Individual provider Active NPI

Melissa Kaye Puthran, PSY.D.

  • Clinical Psychologist
  • Indianapolis, IN
National Provider Identifier
1386169506
Registry record updated Aug 24, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
20043266B Issued in IN
Practice address
4401 Central Ave
Indianapolis, IN 46205-1822
Phone
(317) 432-4131
NPI assigned
Aug 9, 2017
Last updated
Aug 24, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 24, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Psychologist 103TC0700X 20043266B IN Primary

Addresses

Primary practice location

4401 Central Ave
Indianapolis, IN 46205-1822

Mailing address

4401 Central Ave
Indianapolis, IN 46205-1822
Phone (317) 432-4131

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
20043266BINMDClinical Psychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Meridian Psychological Associates Clinical Current Accepting new patients

Locations

4401 Central Ave
Indianapolis, IN 46205
Phone (317) 923-2333

921 E 86th St
Ste 205
Indianapolis, IN 46240
Phone (317) 816-2273

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1502236800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1692835200000",
    "number": "1386169506",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4401 CENTRAL AVE",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462051822",
            "telephone_number": "317-432-4131"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4401 CENTRAL AVE",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462051822",
            "telephone_number": "317-432-4131"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PUTHRAN",
        "first_name": "MELISSA",
        "middle_name": "KAYE",
        "name_prefix": "Dr.",
        "credential": "PSY.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-08-09",
        "last_updated": "2023-08-24",
        "certification_date": "2023-08-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "IN",
            "license": "20043266B",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Indianapolis, IN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 24, 2023; 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.