NPIMap

Organization Active NPI

Mahan and Associates, LLC

  • School Psychologist
  • Terre Haute, IN
National Provider Identifier
1144423609
Registry record updated Jul 30, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
School PsychologistTaxonomy code 103TS0200X
License
20041149 Issued in IN
Legal business name
MAHAN AND ASSOCIATES, LLC
Practice address
1400 E Pugh Dr
Suite 3
Terre Haute, IN 47802-3942
Phone
(812) 236-9569
Fax
(812) 237-3964
NPI assigned
Jun 11, 2007
Last updated
Jul 30, 2010By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 30, 2010

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

Authorized official

Name
Suellyn Mahan, PH.DNPI 1316930357
Title
Owner
Phone
(812) 236-9569

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
PsychologistGroup: 193200000X MULTI-SPECIALTY GROUP 103T00000X 20041149 IN
Clinical Child & Adolescent PsychologistGroup: 193200000X MULTI-SPECIALTY GROUP 103TC2200X 20041149 IN
School PsychologistGroup: 193200000X MULTI-SPECIALTY GROUP 103TS0200X 20041149 IN Primary

Addresses

Primary practice location

1400 E Pugh Dr
Suite 3
Terre Haute, IN 47802-3942

Mailing address

1400 E Pugh Dr
Suite 3
Terre Haute, IN 47802-3942
Phone (812) 236-9569

Other identifiers 1

IdentifierTypeStateIssuer
200927070MedicaidIN

National Provider Directory

National Provider Directory

Locations

1400 E Pugh Dr
Ste 3
Terre Haute, IN 47802
Phone (812) 236-9569

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1181520000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1280448000000",
    "number": "1144423609",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1400 E PUGH DR",
            "address_2": "SUITE 3",
            "city": "TERRE HAUTE",
            "state": "IN",
            "postal_code": "478023942",
            "telephone_number": "812-236-9569",
            "fax_number": "812-237-3964"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1400 E PUGH DR",
            "address_2": "SUITE 3",
            "city": "TERRE HAUTE",
            "state": "IN",
            "postal_code": "478023942",
            "telephone_number": "812-236-9569",
            "fax_number": "812-237-3964"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MAHAN AND ASSOCIATES, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-06-11",
        "last_updated": "2010-07-30",
        "status": "A",
        "authorized_official_last_name": "MAHAN",
        "authorized_official_first_name": "SUELLYN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "812-236-9569",
        "authorized_official_credential": "PH.D"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychologist",
            "state": "IN",
            "license": "20041149",
            "primary": false
        },
        {
            "code": "103TC2200X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychologist, Clinical Child & Adolescent",
            "state": "IN",
            "license": "20041149",
            "primary": false
        },
        {
            "code": "103TS0200X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychologist, School",
            "state": "IN",
            "license": "20041149",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200927070",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Terre Haute, IN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 30, 2010; 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.