Mary Mirro, Psy. D., HSPP, LLC

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

20041970A Issued in IN

Legal business name

MARY MIRRO, PSY. D., HSPP, LLC

Practice address

1024 Sterling CT
Crown Point, IN 46307-2686

Phone

(219) 805-7407

NPI assigned

Mar 9, 2007

Organization subpart

No

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

Authorized official

Name

Mary Mirro, PSY DNPI 1407857972

Title

Psychologist/Owner

Phone

(219) 805-7407

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in IN

Enrollment records 1

Locations

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Mary Mirro, PSYD

  • Psychologist
  • Crown Point, IN
  • NPI 1407857972
  Medicare reassignment NPD Authorized official
• David R Bucur, PH.D.

  • Clinical Psychologist
  • Merrillville, IN
  • NPI 1376792689
  NPD (past)
• Gregory Hyde, PSY.D.

  • Clinical Psychologist
  • Merrillville, IN
  • NPI 1235243619
  NPD (past)
• Carl Stephen Moisoff, PSYD

  • Clinical Psychologist
  • Merrillville, IN
  • NPI 1083680987
  NPD (past)

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

{
    "created_epoch": "1173398400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1671580800000",
    "number": "1114059953",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1024 STERLING CT",
            "city": "CROWN POINT",
            "state": "IN",
            "postal_code": "463072686",
            "telephone_number": "219-805-7407"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1024 STERLING CT",
            "city": "CROWN POINT",
            "state": "IN",
            "postal_code": "463072686",
            "telephone_number": "219-805-7407"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MARY MIRRO, PSY. D., HSPP, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-09",
        "last_updated": "2022-12-21",
        "certification_date": "2022-12-21",
        "status": "A",
        "authorized_official_last_name": "MIRRO",
        "authorized_official_first_name": "MARY",
        "authorized_official_title_or_position": "PSYCHOLOGIST/OWNER",
        "authorized_official_telephone_number": "219-805-7407",
        "authorized_official_credential": "PSY D"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychologist, Clinical",
            "state": "IN",
            "license": "20041970A",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200529940",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Jennifer Martin, COTA
• Alexis Martinez
• Lysabelle Martinez, RBT
• Selma Martinez, BCBA
• David James Martus, PT
• Carrie Beth Mason, LCSW
• John Massimilian, DO
• Cheyenne Mathas
• Reinaldo Matias Jr., PHD
• Brenda Matijevich, RN

• Clinical Psychologist in Crown Point, IN
• Providers in Crown Point, IN by specialty
• Clinical Psychologist in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 21, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.