Individual provider Active NPI

Julie Nethercutt, PSY.D. HSPP

  • Clinical Psychologist
  • Warsaw, IN
National Provider Identifier
1124484522
Registry record updated Mar 17, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
20040829A Issued in IN
Practice address
3201 E Center Street Ext
Warsaw, IN 46582-3907
Phone
(574) 267-1700
Fax
(574) 267-0017
NPI assigned
Jan 14, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 17, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Psychologist 103TC0700X 20040829A IN Primary

Addresses

Primary practice location

3201 E Center Street Ext
Warsaw, IN 46582-3907

Mailing address

3201 E Center Street Ext
Warsaw, IN 46582-3907
Phone (574) 267-1700

Other practice location 1

3120B Windsor Ct
Elkhart, IN 46514-5556
Phone (574) 267-1700

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IN
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20160829003285 IN Practitioner - Clinical Psychologist 8224323241 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
McArthur Mental Health Services CurrentSince Aug 10, 2016 Accepting new patients
McArthur Mental Health Services PastSince Aug 10, 2016 Accepting new patients

Locations

3120B Windsor Ct
Elkhart, IN 46514
Phone (574) 264-3344

3201 E Center Street Ext
Warsaw, IN 46582
Phone (574) 253-2220

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1452729600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1521244800000",
    "number": "1124484522",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3201 E CENTER STREET EXT",
            "city": "WARSAW",
            "state": "IN",
            "postal_code": "465823907",
            "telephone_number": "574-267-1700",
            "fax_number": "574-267-0017"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3201 E CENTER STREET EXT",
            "city": "WARSAW",
            "state": "IN",
            "postal_code": "465823907",
            "telephone_number": "574-267-1700",
            "fax_number": "574-267-0017"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3120B Windsor Ct",
            "address_purpose": "LOCATION",
            "city": "Elkhart",
            "state": "IN",
            "postal_code": "465145556",
            "country_code": "US",
            "telephone_number": "574-267-1700",
            "fax_number": "574-267-0017",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "NETHERCUTT",
        "first_name": "JULIE",
        "credential": "PSY.D. HSPP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-01-14",
        "last_updated": "2018-03-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "IN",
            "license": "20040829A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Warsaw, IN

Sources for this page

Verify at the official NPI Registry.