Individual provider Active NPI

Alicia Simle, PSY.D., HSPP

  • Clinical Psychologist
  • Indianapolis, IN
National Provider Identifier
1447654330
Registry record updated Jul 9, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
20042807A Issued in IN
Practice address
2506 Willowbrook Pkwy
Suite 300
Indianapolis, IN 46205-1564
Phone
(317) 574-1254
Fax
(317) 674-0060
NPI assigned
Oct 21, 2014
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 9, 2015

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 20042807A IN Primary

Addresses

Primary practice location

2506 Willowbrook Pkwy
Suite 300
Indianapolis, IN 46205-1564

Mailing address

9615 E 148TH St
Suite 1
Noblesville, IN 46060-4360
Phone (317) 587-0500

Other identifiers 1

IdentifierTypeStateIssuer
201262590MedicaidIN

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
20042807AINMDClinical Psychologist

NPI Registry JSON

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

{
    "created_epoch": "1413849600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1436400000000",
    "number": "1447654330",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9615 E 148TH ST",
            "address_2": "SUITE 1",
            "city": "NOBLESVILLE",
            "state": "IN",
            "postal_code": "460604360",
            "telephone_number": "317-587-0500",
            "fax_number": "317-674-0060"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2506 WILLOWBROOK PKWY",
            "address_2": "SUITE 300",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462051564",
            "telephone_number": "317-574-1254",
            "fax_number": "317-674-0060"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SIMLE",
        "first_name": "ALICIA",
        "name_prefix": "Dr.",
        "credential": "PSY.D., HSPP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-10-21",
        "last_updated": "2015-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "IN",
            "license": "20042807A",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "201262590",
            "state": "IN"
        }
    ],
    "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 Jul 9, 2015; 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.