NPIMap

Organization Active NPI

Corinthian Christian Center

  • Psychologist
  • Gary, IN
National Provider Identifier
1679623235
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
License
20040617A Issued in IN
Legal business name
CORINTHIAN CHRISTIAN CENTER
Practice address
667 Van Buren St
Gary, IN 46402-2240
Phone
(219) 885-5819
Fax
(219) 661-8892
NPI assigned
Jan 12, 2007
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
Jan Gold
Title
Office Manager
Phone
(219) 662-2224

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
PsychologistGroup: 193400000X SINGLE SPECIALTY GROUP 103T00000X 20040617A IN Primary

Addresses

Primary practice location

667 Van Buren St
Gary, IN 46402-2240

Mailing address

PO Box 9135
Gary, IN 46402-9135
Phone (219) 885-5819

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1168560000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1679623235",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 9135",
            "city": "GARY",
            "state": "IN",
            "postal_code": "464029135",
            "telephone_number": "219-885-5819",
            "fax_number": "219-661-8892"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "667 VAN BUREN ST",
            "city": "GARY",
            "state": "IN",
            "postal_code": "464022240",
            "telephone_number": "219-885-5819",
            "fax_number": "219-661-8892"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CORINTHIAN CHRISTIAN CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-12",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "GOLD",
        "authorized_official_first_name": "JAN",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "219-662-2224"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychologist",
            "state": "IN",
            "license": "20040617A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Gary, 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.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.