Terence Neal Anderson, PH.D.
Individual provider Active NPI Health Service Psychologist · La Porte, IN
NPI 1275614869 · NPPES record last updated Jan 7, 2008
Key facts
- NPI
- 1275614869
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Health Service Psychologist 103TH0100X
- License
- 20010366 HSPP (IN)
- Practice address
- 318 Pine Lake Ave
La Porte, IN 46350-3061 - Phone
- (219) 324-6263
- Fax
- (219) 324-6263
- NPI assigned
- Oct 18, 2006
- Sex
- Male
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 20010366 HSPP | IN | MD | Clinical Psychologist |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychologist | 103T00000X | 20010366 HSPP | IN | |
| Clinical Psychologist | 103TC0700X | 20010366 HSPP | IN | |
| Health Service Psychologist | 103TH0100X | 20010366 HSPP | IN | Yes |
Addresses
Primary practice location
318 Pine Lake Ave
La Porte, IN 46350-3061
Mailing address
318 Pine Lake Ave
Box 668
Laporte, IN 46352-0668
Phone (219) 324-6263
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 010676 | Other | IN | VALUE OPTION |
| 000000183576 | Other | IN | BLUE CROSS |
Other providers in La Porte, IN
- American Medical Oxygen Sales Corp.
- Anam Cara Stables
- Jeffrey Anderson
- Paula Anderson
- Susan Diane Anderson
- Anesthesia Associates of Laporte PC
- Anesthesia Consulting and Clinical Specialists, LLC
- Diane Apostoloff
- App of Ohio HM PLLC
- Isabella Reagan Applegarth
All providers in La Porte, IN · Health Service Psychologist in Indiana
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jan 7, 2008. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.