Wellhome Psychology, PC
Organization Active NPI Social Worker · Medaryville, IN
NPI 1972106599 · NPPES record last updated Dec 29, 2024
Key facts
- NPI
- 1972106599
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Social Worker 104100000X
- Legal business name
- WELLHOME PSYCHOLOGY, PC
- Practice address
- 15262 W 400 N
Medaryville, IN 47957-8107 - Phone
- (219) 804-6262
- Fax
- (877) 497-6001
- NPI assigned
- Nov 17, 2020
- Organization subpart
- No
Authorized official
- Name
- Dr. Jennifer Dyarman, PSYD LCSW LCAC
- Title
- Director
- Phone
- (260) 413-6994
Practitioners 4
-
Emily Marie Liechty, MSW
-
Jennifer Dyarman, PSYD LCSW LCAC
-
Leah Villavicencio, LMHC
-
Laura Rafaela Borowiec, LMHC
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in IN
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20201223000380 | IN | Part B Supplier - Clinic/Group Practice | 3476965070 |
Receives reassigned benefits from 5 practitioners Practice locations: Fort Wayne, IN; Merrillville, IN |
National Provider Directory
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Social Worker |
104100000X | Yes |
Addresses
Primary practice location
15262 W 400 N
Medaryville, IN 47957-8107
Mailing address
417 W 81St Ave # 132
Merrillville, IN 46410-5317
Phone (219) 804-6262
Other names
- Jennifer Dyarman-Hunter
Other providers in Medaryville, IN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Dec 29, 2024. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.