Individual provider Active NPI

Daniel L. Schultz, PH.D.

  • Clinical Psychologist
  • Valparaiso, IN
National Provider Identifier
1356347710
Registry record updated Jul 6, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
20010329 Issued in IN
Practice address
15 N Franklin St.
Clinical Psychology Center PC
Valparaiso, IN 46383
Phone
(219) 462-4770
Fax
(219) 464-8156
NPI assigned
Jun 21, 2005
Reactivated
Mar 27, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 6, 2011

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Psychologist 103TC0700X 20010329A IN
Clinical Psychologist 103TC0700X 20010329 IN Primary

Addresses

Primary practice location

15 N Franklin St.
Clinical Psychology Center PC
Valparaiso, IN 46383

Mailing address

15 N Franklin St. Suite 230
Clinical Psychology Center PC
Valparaiso, IN 46383
Phone (219) 462-4770

Other identifiers 1

IdentifierTypeStateIssuer
100208230AMedicaidIN

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20110330000025 IN Practitioner - Clinical Psychologist 7416919428 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 1978
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

15 Franklin St
Suite 230
Valparaiso, IN 46383-3785
Phone (219) 462-4770

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
20010329INMDClinical Psychologist
20010329AINMDClinical Psychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Clinical Psychology Center, P.C. Clinical CurrentSince Aug 1, 1979 Accepting new patients

Locations

15 Franklin St
Ste 230
Valparaiso, IN 46383
Phone (219) 462-4770

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1119312000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1309910400000",
    "number": "1356347710",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15 N FRANKLIN ST. SUITE 230",
            "address_2": "CLINICAL PSYCHOLOGY CENTER PC",
            "city": "VALPARAISO",
            "state": "IN",
            "postal_code": "46383",
            "telephone_number": "219-462-4770",
            "fax_number": "219-464-8156"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15 N FRANKLIN ST.",
            "address_2": "CLINICAL PSYCHOLOGY CENTER PC",
            "city": "VALPARAISO",
            "state": "IN",
            "postal_code": "46383",
            "telephone_number": "219-462-4770",
            "fax_number": "219-464-8156"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SCHULTZ",
        "first_name": "DANIEL",
        "middle_name": "L.",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-06-21",
        "last_updated": "2011-07-06",
        "deactivation_date": "2006-03-21",
        "reactivation_date": "2006-03-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "IN",
            "license": "20010329A",
            "primary": false
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "IN",
            "license": "20010329",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100208230A",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Valparaiso, IN

Sources for this page

Verify at the official NPI Registry.