Individual provider Active NPI

Julia Gadlage, PSYD

  • Clinical Psychologist
  • Terre Haute, IN
National Provider Identifier
1578886875
Registry record updated Oct 20, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
20042392A Issued in IN
Practice address
620 8TH Ave
Terre Haute, IN 47804-2744
Phone
(812) 231-8200
NPI assigned
Mar 2, 2010
Last updated
Oct 20, 2020By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 20, 2020

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 20042392A IN Primary

Addresses

Primary practice location

620 8TH Ave
Terre Haute, IN 47804-2744

Mailing address

PO Box 553
Linton, IN 47441-0553

Other practice location 1

26 N Arsenal Ave
Indianapolis, IN 46201-3808
Phone (317) 632-0123

Other identifiers 1

IdentifierTypeStateIssuer
200982510MedicaidIN

Other names 1

  • Dr. Julia Friend Former name

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
I20100608000446 IN Practitioner - Clinical Psychologist 3779613351 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
20042392AINMDClinical Psychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Hamilton Center, Inc. CurrentSince May 17, 2010 Accepting new patients
Hamilton Center Inc. CurrentSince May 17, 2010 Accepting new patients

Locations

620 8th Ave
Terre Haute, IN 47804
Phone (812) 231-8200

Organizations & group practices 2

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": "1267488000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1603152000000",
    "number": "1578886875",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 553",
            "city": "LINTON",
            "state": "IN",
            "postal_code": "474410553"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "620 8TH AVE",
            "city": "TERRE HAUTE",
            "state": "IN",
            "postal_code": "478042744",
            "telephone_number": "812-231-8200"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "26 N Arsenal Ave",
            "address_purpose": "LOCATION",
            "city": "Indianapolis",
            "state": "IN",
            "postal_code": "462013808",
            "country_code": "US",
            "telephone_number": "317-632-0123",
            "fax_number": "317-632-4363",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GADLAGE",
        "first_name": "JULIA",
        "name_prefix": "Dr.",
        "credential": "PSYD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-03-02",
        "last_updated": "2020-10-20",
        "certification_date": "2020-10-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "IN",
            "license": "20042392A",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200982510",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JULIA",
            "last_name": "FRIEND",
            "prefix": "DR.",
            "credential": "PSYD",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Terre Haute, IN

Sources for this page

Verify at the official NPI Registry.