Clinical Psychology Associates, PC

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

Legal business name

CLINICAL PSYCHOLOGY ASSOCIATES, PC

Practice address

9111 Broadway
Suite Q
Merrillville, IN 46410

Phone

(219) 736-0003

Fax

(219) 756-2315

NPI assigned

Nov 6, 2006

Last updated

Dec 19, 2014By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Kathleen M Pueschel, PH.D.

Title

President

Phone

(219) 736-0003

Specialties & licenses 1

Addresses

Other identifiers 2

Locations

Practitioners 1

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.

• Lisa D Prince, PSYD

  • Clinical Psychologist
  • Merrillville, IN
  • NPI 1801903018
  NPD (past)

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

{
    "created_epoch": "1162771200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1418947200000",
    "number": "1396824694",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 10126",
            "city": "MERRILLVILLE",
            "state": "IN",
            "postal_code": "464110126",
            "telephone_number": "219-736-0003",
            "fax_number": "219-756-2315"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9111 BROADWAY",
            "address_2": "SUITE Q",
            "city": "MERRILLVILLE",
            "state": "IN",
            "postal_code": "46410",
            "telephone_number": "219-736-0003",
            "fax_number": "219-756-2315"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CLINICAL PSYCHOLOGY ASSOCIATES, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-06",
        "last_updated": "2014-12-19",
        "status": "A",
        "authorized_official_last_name": "PUESCHEL",
        "authorized_official_first_name": "KATHLEEN",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "219-736-0003",
        "authorized_official_credential": "PH.D."
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100389940",
            "state": "IN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100389940A",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Micaela Rei Claudio, RBT
• Nicole Clay, RBT
• Beatrice Clayborn
• Kailah Cleveland
• Marissa Nichole Cline, BCBA
• Lena Danielle Clouse, PHARMD
• CM Sunshine Home Healthcare, Inc.
• Ryan C Cmejrek, M.D.
• Morgan Coates
• Alexis Coffman

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 19, 2014; 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.