NPIMap

Organization Active NPI

Psychological Laboratories of Indianapolis, PC

  • Psychologist
  • Indianapolis, NE
National Provider Identifier
1295853992
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
Legal business name
PSYCHOLOGICAL LABORATORIES OF INDIANAPOLIS, PC
Practice address
2625 N Meridian St
Suite 18
Indianapolis, NE 46208
Phone
(317) 925-1818
Fax
(317) 924-6582
NPI assigned
Mar 27, 2007
Last updated
Aug 22, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Kurt A Moehle, PH.D., H.S.P.P.
Title
Owner
Phone
(317) 925-1818

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychologist 103T00000X IN Primary

Addresses

Primary practice location

2625 N Meridian St
Suite 18
Indianapolis, NE 46208

Mailing address

2625 N Meridian St
Suite 18
Indianapolis, NE 46208
Phone (317) 925-1818

National Provider Directory

National Provider Directory

Locations

2625 N Meridian St
Ste 18
Indianapolis, IN 46208
Phone (317) 925-1818

Practitioners & affiliated clinicians

Practitioners 28

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.

View all 28

NPI Registry JSON

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

{
    "created_epoch": "1174953600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1295853992",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2625 N MERIDIAN ST",
            "address_2": "SUITE 18",
            "city": "INDIANAPOLIS",
            "state": "NE",
            "postal_code": "46208",
            "telephone_number": "317-925-1818",
            "fax_number": "317-924-6582"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2625 N MERIDIAN ST",
            "address_2": "SUITE 18",
            "city": "INDIANAPOLIS",
            "state": "NE",
            "postal_code": "46208",
            "telephone_number": "317-925-1818",
            "fax_number": "317-924-6582"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PSYCHOLOGICAL LABORATORIES OF INDIANAPOLIS, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-27",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "MOEHLE",
        "authorized_official_first_name": "KURT",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "317-925-1818",
        "authorized_official_credential": "PH.D., H.S.P.P."
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "IN",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.