NPIMap

Organization Active NPI

Christian Psychological Services, P.C.

  • Clinical Psychologist
  • Shipshewana, IN
National Provider Identifier
1205915477
Registry record updated Mar 16, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
20041285A Issued in IN
Legal business name
CHRISTIAN PSYCHOLOGICAL SERVICES, P.C.
Practice address
245 N. Morton St.
Second Floor
Shipshewana, IN 46565-0414
Phone
(260) 336-3362
Fax
(260) 768-7114
NPI assigned
Nov 6, 2006
Last updated
Mar 16, 2009By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 16, 2009

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

Authorized official

Name
Dr. Janelle Warner Ashby, PSY.D.NPI 1154303238
Title
President
Phone
(260) 336-3362

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 Psychologist 103TC0700X 20041285A IN Primary

Addresses

Primary practice location

245 N. Morton St.
Second Floor
Shipshewana, IN 46565-0414

Mailing address

PO Box 414
Shipshewana, IN 46565-0414
Phone (260) 336-3362

Other identifiers 2

IdentifierTypeStateIssuer
000000388789OtherINANTHEM BC/BS
200176640BMedicaidIN

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

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": "1162771200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1237161600000",
    "number": "1205915477",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 414",
            "city": "SHIPSHEWANA",
            "state": "IN",
            "postal_code": "465650414",
            "telephone_number": "260-336-3362",
            "fax_number": "260-768-7114"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "245 N. MORTON ST.",
            "address_2": "SECOND FLOOR",
            "city": "SHIPSHEWANA",
            "state": "IN",
            "postal_code": "465650414",
            "telephone_number": "260-336-3362",
            "fax_number": "260-768-7114"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CHRISTIAN PSYCHOLOGICAL SERVICES, P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-06",
        "last_updated": "2009-03-16",
        "status": "A",
        "authorized_official_last_name": "ASHBY",
        "authorized_official_first_name": "JANELLE",
        "authorized_official_middle_name": "WARNER",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "260-336-3362",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PSY.D."
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "IN",
            "license": "20041285A",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM BC/BS",
            "identifier": "000000388789",
            "state": "IN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200176640B",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Shipshewana, IN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 16, 2009; 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.