Jared Eaton, PSYD, HSPP

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

20042868A Issued in IN

Practice address

1441 E 84TH PL
Merrillville, IN 46410-6451

Phone

(219) 736-9115

Fax

(219) 794-2010

NPI assigned

Aug 3, 2010

Last updated

Sep 17, 2015By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

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

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

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

• Southlake Community Mental Health Center Inc.

  dba Regional Mental Health Center

  • Clinic/Center
  • Merrillville, IN
  • NPI 1821081290
  Medicare reassignment NPD

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

{
    "created_epoch": "1280793600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1442448000000",
    "number": "1154635043",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8400 LOUISIANA ST",
            "city": "MERRILLVILLE",
            "state": "IN",
            "postal_code": "464106385",
            "telephone_number": "219-757-1928",
            "fax_number": "219-757-1950"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1441 E 84TH PL",
            "city": "MERRILLVILLE",
            "state": "IN",
            "postal_code": "464106451",
            "telephone_number": "219-736-9115",
            "fax_number": "219-794-2010"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EATON",
        "first_name": "JARED",
        "name_prefix": "Mr.",
        "credential": "PSYD, HSPP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2010-08-03",
        "last_updated": "2015-09-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "IN",
            "license": "20042868A",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "201313820",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Ashley Renee Earle
• Darren Earnshaw, PT
• Earthworks Center Inc.
• Easy Living Enterprises (Easy Living Senior Social Center)
• Ethel Mae Eaton
• Rita Eaton, BA
• Marcus Eaves
• Courtney Rosa Ebert, MA, NCC, LMHC-A
• Leslie Echeverria
• Brittany Eckhoff, PA-C

• Clinical Psychologist in Merrillville, IN
• Providers in Merrillville, IN by specialty
• Clinical Psychologist in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 17, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.