Organization Active NPI

Comprehensive Psychology Services, P.C.

  • Clinical Psychologist
  • Chesterton, IN
National Provider Identifier
1659435873
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
57000092A Issued in IN
Legal business name
COMPREHENSIVE PSYCHOLOGY SERVICES, P.C.
Practice address
1100 S Calumet Rd
Suite 3
Chesterton, IN 46304-3275
Phone
(219) 921-5400
Fax
(219) 926-8141
NPI assigned
Dec 21, 2006
Last updated
Aug 22, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Robert James Walsh, PSY.D.NPI 1548321037
Title
Owner
Phone
(219) 921-5400

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Psychologist 103TC0700X 57000092A IN Primary

Addresses

Primary practice location

1100 S Calumet Rd
Suite 3
Chesterton, IN 46304-3275

Mailing address

1100 S Calumet Rd
Suite 3
Chesterton, IN 46304-3275
Phone (219) 921-5400

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IN

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040223000128 IN Part B Supplier - Clinic/Group Practice 4183510787 Receives reassigned benefits from 1 practitioner
Practice locations: Chesterton, IN

National Provider Directory

National Provider Directory

Locations

1100 S Calumet Rd
Ste 3
Chesterton, IN 46304
Phone (219) 921-5400

Practitioners & affiliated clinicians

Practitioners 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1166659200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1659435873",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1100 S CALUMET RD",
            "address_2": "SUITE 3",
            "city": "CHESTERTON",
            "state": "IN",
            "postal_code": "463043275",
            "telephone_number": "219-921-5400",
            "fax_number": "219-926-8141"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1100 S CALUMET RD",
            "address_2": "SUITE 3",
            "city": "CHESTERTON",
            "state": "IN",
            "postal_code": "463043275",
            "telephone_number": "219-921-5400",
            "fax_number": "219-926-8141"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COMPREHENSIVE PSYCHOLOGY SERVICES, P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-12-21",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "WALSH",
        "authorized_official_first_name": "ROBERT",
        "authorized_official_middle_name": "JAMES",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "219-921-5400",
        "authorized_official_credential": "PSY.D."
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "IN",
            "license": "57000092A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chesterton, IN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.