Associates in Clinical Psychology PC

Primary specialty

Psychiatric Residential Treatment FacilityTaxonomy code 323P00000X

Legal business name

ASSOCIATES IN CLINICAL PSYCHOLOGY PC

Practice address

317 West Monroe St
Plymouth, IN 46563

Phone

(574) 936-8004

Fax

(574) 936-8225

NPI assigned

Jan 9, 2007

Last updated

Aug 22, 2020By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Dr. Marc Allen Zackhelm, PHD

Title

President

Phone

(630) 355-1433

Specialties & licenses 1

Addresses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1168300800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1063561272",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1801 SHORE ACRES RD",
            "city": "LAKE BLUFF",
            "state": "IL",
            "postal_code": "60044",
            "telephone_number": "630-355-1433",
            "fax_number": "847-295-9841"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "317 WEST MONROE ST",
            "city": "PLYMOUTH",
            "state": "IN",
            "postal_code": "46563",
            "telephone_number": "574-936-8004",
            "fax_number": "574-936-8225"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ASSOCIATES IN CLINICAL PSYCHOLOGY PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-09",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "ZACKHELM",
        "authorized_official_first_name": "MARC",
        "authorized_official_middle_name": "ALLEN",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "630-355-1433",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PHD"
    },
    "taxonomies": [
        {
            "code": "323P00000X",
            "taxonomy_group": "",
            "desc": "Psychiatric Residential Treatment Facility",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.