Jill Gardner, PHD

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

20041319A Issued in IN

Practice address

215 W Indiana Ave
Chesterton, IN 46304-2457

Phone

(219) 921-0705

Fax

(219) 921-0557

NPI assigned

Dec 23, 2006

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in IN

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Clinical Psychologist

Education

Other, 1997

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Duneland Counseling Center IncGroup PAC ID 7810958949, 6 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Philosophy

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Duneland Counseling Center, Inc.

  • Clinical Psychologist
  • Chesterton, IN
  • NPI 1528181476
  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1166832000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1346305091",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "215 W INDIANA AVE",
            "city": "CHESTERTON",
            "state": "IN",
            "postal_code": "463042457",
            "telephone_number": "219-921-0705",
            "fax_number": "219-921-0557"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "215 W INDIANA AVE",
            "city": "CHESTERTON",
            "state": "IN",
            "postal_code": "463042457",
            "telephone_number": "219-921-0705",
            "fax_number": "219-921-0557"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GARDNER",
        "first_name": "JILL",
        "credential": "PHD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-12-23",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "IN",
            "license": "20041319A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Anthony Galoozis
• James P. Gano, D.C.
• Deborah G Garceau, OTA
• Maxwell Joseph Garcia, PA-C
• Emily N Gardenhire, OTD, OTR/L
• Hannah Garner, OTR
• Rylee Garza-Valtierra, RBT
• Virgil Gassoway
• Eric Gatewood, PTA
• Shannon Michele Gavin, MSN, RN, FNP-BC

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.