Active NPI
Stephanie Luallin, HSPP
- Psychologist
- South Bend, IN
National Provider Identifier
1639847155
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychologist
- Practice address
- 1827 E Ireland Rd
South Bend, IN 46614-2845 - Phone
- (574) 387-4313
- NPI assigned
- Aug 31, 2021
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychologist | 103T00000X | Primary |
Addresses
Primary practice location
1827 E Ireland Rd
South Bend, IN 46614-2845
Mailing address
1827 E Ireland Rd
South Bend, IN 46614-2845
Phone (574) 387-4313
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)
- Not enrolled
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Vav Operations Ia LLC | Past | Accepting new patients | |
| Vav Operations LLC | Past | Accepting new patients |
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 and National Provider Directory roles.
-
- Community/Behavioral Health Agency
- South Bend, IN
- NPI 1942576905
-
- Community/Behavioral Health Agency
- Davenport, IA
- NPI 1194439661
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1630368000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1630368000000",
"number": "1639847155",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1827 E IRELAND RD",
"city": "SOUTH BEND",
"state": "IN",
"postal_code": "466142845",
"telephone_number": "574-387-4313"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1827 E IRELAND RD",
"city": "SOUTH BEND",
"state": "IN",
"postal_code": "466142845",
"telephone_number": "574-387-4313"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LUALLIN",
"first_name": "STEPHANIE",
"credential": "HSPP",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2021-08-31",
"last_updated": "2021-08-31",
"certification_date": "2021-08-31",
"status": "A"
},
"taxonomies": [
{
"code": "103T00000X",
"taxonomy_group": "",
"desc": "Psychologist",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in South Bend, IN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 31, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.