NPIMap

Organization Active NPI

Psych Consults

  • Clinical Psychologist
  • La Porte, IN
National Provider Identifier
1174899488
Registry record updated Mar 30, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
20042166A Issued in IN
Legal business name
PSYCH CONSULTS
Practice address
316 Lincolnway
La Porte, IN 46350-2413
Phone
(219) 898-5645
Fax
(219) 325-0855
NPI assigned
Mar 30, 2012
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 30, 2012

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

Authorized official

Name
Dr. Thomas Michael Allen, PSYD, HSPPNPI 1972592798
Title
Clinical Psychologist
Phone
(219) 898-5645

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical PsychologistGroup: 193200000X MULTI-SPECIALTY GROUP 103TC0700X 20042166A IN Primary

Addresses

Primary practice location

316 Lincolnway
La Porte, IN 46350-2413

Mailing address

316 Lincolnway
La Porte, IN 46350-2413
Phone (219) 898-5645

National Provider Directory

National Provider Directory

Locations

316 Lincolnway
Laporte, IN 46350
Phone (219) 707-0178

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1333065600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1333065600000",
    "number": "1174899488",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "316 LINCOLNWAY",
            "city": "LA PORTE",
            "state": "IN",
            "postal_code": "463502413",
            "telephone_number": "219-898-5645",
            "fax_number": "219-325-0855"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "316 LINCOLNWAY",
            "city": "LA PORTE",
            "state": "IN",
            "postal_code": "463502413",
            "telephone_number": "219-898-5645",
            "fax_number": "219-325-0855"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PSYCH CONSULTS",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-03-30",
        "last_updated": "2012-03-30",
        "status": "A",
        "authorized_official_last_name": "ALLEN",
        "authorized_official_first_name": "THOMAS",
        "authorized_official_middle_name": "MICHAEL",
        "authorized_official_title_or_position": "CLINICAL PSYCHOLOGIST",
        "authorized_official_telephone_number": "219-898-5645",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PSYD, HSPP"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychologist, Clinical",
            "state": "IN",
            "license": "20042166A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in La Porte, IN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 30, 2012; 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.