NPIMap

Organization Active NPI

Mary E Locke PHD HSPP LLC

  • Psychologist
  • Fort Wayne, IN
National Provider Identifier
1134344823
Registry record updated Aug 22, 2020
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Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
License
20040180 Issued in IN
Legal business name
MARY E LOCKE PHD HSPP LLC
Practice address
7337 W Jefferson Blvd Ste 175
Fort Wayne, IN 46804-6286
Phone
(317) 272-1838
Fax
(317) 272-0072
NPI assigned
Apr 16, 2007
Last updated
Aug 22, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Mary E Locke, PHD HSPP
Title
Pres
Phone
(317) 272-1838

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
PsychologistGroup: 193400000X SINGLE SPECIALTY GROUP 103T00000X 20040180 IN Primary

Addresses

Primary practice location

7337 W Jefferson Blvd Ste 175
Fort Wayne, IN 46804-6286

Mailing address

7337 W Jefferson Blvd Ste 175
Fort Wayne, IN 46804-6286
Phone (317) 272-1838

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1176681600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1134344823",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7337 W JEFFERSON BLVD STE 175",
            "city": "FORT WAYNE",
            "state": "IN",
            "postal_code": "468046286",
            "telephone_number": "317-272-1838",
            "fax_number": "317-272-0072"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7337 W JEFFERSON BLVD STE 175",
            "city": "FORT WAYNE",
            "state": "IN",
            "postal_code": "468046286",
            "telephone_number": "317-272-1838",
            "fax_number": "317-272-0072"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MARY E LOCKE PHD HSPP LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-04-16",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "LOCKE",
        "authorized_official_first_name": "MARY",
        "authorized_official_middle_name": "E",
        "authorized_official_title_or_position": "PRES",
        "authorized_official_telephone_number": "317-272-1838",
        "authorized_official_credential": "PHD HSPP"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychologist",
            "state": "IN",
            "license": "20040180",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Wayne, IN

Sources for this page

  • 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.