Organization Active NPI

Modern Strength Psychology Center

  • Psychologist
  • Indianapolis, IN
National Provider Identifier
1255039079
Registry record updated Sep 22, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
Legal business name
MODERN STRENGTH PSYCHOLOGY CENTER
Practice address
9102 N Meridian St Ste 550
Indianapolis, IN 46260-1899
Phone
(614) 448-6693
NPI assigned
Feb 21, 2023
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 22, 2023

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

Authorized official

Name
Dr. Kassandra E Lowery, PH.D.NPI 1053830083
Title
Owner, Clinical Neuropsychologist
Phone
(317) 559-3221

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
PsychologistGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 103T00000X Primary

Addresses

Primary practice location

9102 N Meridian St Ste 550
Indianapolis, IN 46260-1899

Mailing address

9102 N Meridian St Ste 550
Indianapolis, IN 46260-1899
Phone (317) 559-3221

Other identifiers 2

IdentifierTypeStateIssuer
1053820083MedicaidIN
1548256795MedicaidIN

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IN

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20230926000748 IN Part B Supplier - Clinic/Group Practice 8426402462 Receives reassigned benefits from 1 practitioner
Practice locations: Indianapolis, IN

National Provider Directory

National Provider Directory

Locations

9102 N Meridian St
Ste 550
Indianapolis, IN 46260
Phone (317) 559-3221

Practitioners & affiliated clinicians

Practitioners 4

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": "1676937600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1695340800000",
    "number": "1255039079",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9102 N MERIDIAN ST STE 550",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462601899",
            "telephone_number": "317-559-3221"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9102 N MERIDIAN ST STE 550",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462601899",
            "telephone_number": "614-448-6693"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MODERN STRENGTH PSYCHOLOGY CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-02-21",
        "last_updated": "2023-09-22",
        "certification_date": "2023-09-22",
        "status": "A",
        "authorized_official_last_name": "LOWERY",
        "authorized_official_first_name": "KASSANDRA",
        "authorized_official_middle_name": "E",
        "authorized_official_title_or_position": "OWNER, CLINICAL NEUROPSYCHOLOGIST",
        "authorized_official_telephone_number": "317-559-3221",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PH.D."
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Psychologist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1053820083",
            "state": "IN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1548256795",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Indianapolis, IN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 22, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.