Nicole Austgen

Individual provider Active NPI Developmental Therapist · Merrillville, IN

NPI 1134817141 · NPPES record last updated Apr 27, 2023

Key facts

NPI
1134817141
Entity type
Individual (NPI type 1)
Primary specialty
Developmental Therapist 222Q00000X
License
10275009 (IN)
Practice address
8690 Broadway Ste a
Merrillville, IN 46410-7034
Phone
(219) 750-9600
NPI assigned
Apr 27, 2023
Sex
Female
Sole proprietor
Yes

Organizations & group practices 1

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.

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
10275009INMDDevelopmental Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Superpsyched, LLC Current
since Apr 30, 2023
Accepting new patients

Locations

8690 Broadway
Ste A
Merrillville, IN 46410
Phone (219) 627-2542

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Developmental Therapist
Group: 193400000X SINGLE SPECIALTY GROUP
222Q00000X 10275009 IN Yes

Addresses

Primary practice location

8690 Broadway Ste a
Merrillville, IN 46410-7034

Mailing address

724 E Main St
Lowell, IN 46356-1841
Phone (219) 688-7157

Other providers in Merrillville, IN

All providers in Merrillville, IN · Developmental Therapist in Indiana

Sources for this page

Verify at the official NPI Registry.