Mary Locke, PH.D. LLC

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

20040180 Issued in IN

Legal business name

MARY LOCKE, PH.D. LLC

Practice address

7337 W Jefferson Blvd
Suite 175
Fort Wayne, IN 46804-6284

Phone

(260) 436-7131

Fax

(260) 436-5123

NPI assigned

Oct 29, 2012

Organization subpart

No

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

Authorized official

Name

Dr. Mary Locke, PH.D.

Title

Psychologist

Phone

(260) 436-7131

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

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

{
    "created_epoch": "1351468800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1351468800000",
    "number": "1548514656",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7337 W JEFFERSON BLVD",
            "address_2": "SUITE 175",
            "city": "FORT WAYNE",
            "state": "IN",
            "postal_code": "468046284",
            "telephone_number": "260-436-7131",
            "fax_number": "260-436-5123"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7337 W JEFFERSON BLVD",
            "address_2": "SUITE 175",
            "city": "FORT WAYNE",
            "state": "IN",
            "postal_code": "468046284",
            "telephone_number": "260-436-7131",
            "fax_number": "260-436-5123"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MARY LOCKE, PH.D. LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-10-29",
        "last_updated": "2012-10-29",
        "status": "A",
        "authorized_official_last_name": "LOCKE",
        "authorized_official_first_name": "MARY",
        "authorized_official_title_or_position": "PSYCHOLOGIST",
        "authorized_official_telephone_number": "260-436-7131",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PH.D."
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychologist, Clinical",
            "state": "IN",
            "license": "20040180",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE",
            "identifier": "220850",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• John E Marx, MD
• Mary Alice Reed, MSW, LCSW, LLC
• Mary E Locke PHD HSPP LLC
• Mary Ellen Argus, DDS, PC
• Mary Lisa Barta LLC
• Mary Oaks Home Care LLP
• Mary Rose LCSW, LLC
• Kelly K Masarira, PT, DPT
• Angelia Mascaro, RN
• Cynthia Mason

• Clinical Psychologist in Fort Wayne, IN
• Providers in Fort Wayne, IN by specialty
• Clinical Psychologist in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 29, 2012; 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.