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
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 10275009 | IN | MD | Developmental Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Superpsyched, LLC | Current |
Accepting new patients |
Locations
8690 Broadway
Ste A
Merrillville, IN 46410
Phone (219) 627-2542
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Developmental Therapist |
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
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- Athletic and Therapeutic Institute of Naperville, LLC
- Rosie Diane Atkinson
- Atlas Home Health Services, Inc.
- Audiology Services Company USA, LLC
- Lauren Elizabeth Avidano
- Adriana M Avila
- Awakenings Counseling Center Incorporated
- Osama G. Ayad
- Autumn Ayala
All providers in Merrillville, IN · Developmental Therapist in Indiana
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Apr 27, 2023. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.