Psychservices Indiana LLC

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

Legal business name

PSYCHSERVICES INDIANA LLC

Practice address

5924 1/2 Hillside Avenue East Dr
Indianapolis, IN 46220-2414

Phone

(317) 910-7581

NPI assigned

Apr 18, 2013

Organization subpart

No

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

Authorized official

Name

Samuel J Moehle

Title

Member/Manager

Phone

(317) 910-7581

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1366243200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1366243200000",
    "number": "1255775490",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5924 1/2 HILLSIDE AVENUE EAST DR",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462202414",
            "telephone_number": "317-910-7581"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5924 1/2 HILLSIDE AVENUE EAST DR",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462202414",
            "telephone_number": "317-910-7581"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PSYCHSERVICES INDIANA LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-04-18",
        "last_updated": "2013-04-18",
        "status": "A",
        "authorized_official_last_name": "MOEHLE",
        "authorized_official_first_name": "SAMUEL",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "MEMBER/MANAGER",
        "authorized_official_telephone_number": "317-910-7581"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychologist, Clinical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Thomas D Pryor, RPH
• Eric N Prystowsky, MD
• Mary Anne Pryzma, MD
• Psychiatry & Behavioral Health Indiana, LLC
• Psychological Evaluation and Counseling Services, PC
• Public Safety Medical Services
• Izabella Puchalski
• Andrew Quentin Pucka
• Jennifer Puckett
• Kristain Joan Puckett, OTR

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 18, 2013; 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.