Active NPI
Colter Snethen, PSY.D.
- Clinical Psychologist
- Indianapolis, IN
National Provider Identifier
1972115608
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- 20043325A
- Practice address
- 6411 S East St Ste a
Indianapolis, IN 46227-2737 - Phone
- (317) 780-5750
- NPI assigned
- Aug 24, 2020
- Sex
- Male
- 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 |
|---|---|---|---|---|
| Clinical Psychologist | 103TC0700X | 20043325A | IN | Primary |
Addresses
Primary practice location
6411 S East St Ste a
Indianapolis, IN 46227-2737
Mailing address
690 English Village Dr Apt 102
Indianapolis, IN 46239-2139
Phone (816) 305-6953
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 20043325A | IN | MD | Clinical Psychologist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Beech Tree Consulting and Psychological Services | Clinical | Current | Accepting new patients |
Locations
6411 S East St
Ste A
Indianapolis, IN 46227
Phone (317) 296-2754
Organizations & group practices 1
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.
-
- Clinical Psychologist
- Indianapolis, IN
- NPI 1619218666
Clinical
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1598227200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1598227200000",
"number": "1972115608",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "690 ENGLISH VILLAGE DR APT 102",
"city": "INDIANAPOLIS",
"state": "IN",
"postal_code": "462392139",
"telephone_number": "816-305-6953"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "6411 S EAST ST STE A",
"city": "INDIANAPOLIS",
"state": "IN",
"postal_code": "462272737",
"telephone_number": "317-780-5750"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SNETHEN",
"first_name": "COLTER",
"credential": "PSY.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2020-08-24",
"last_updated": "2020-08-24",
"certification_date": "2020-08-24",
"status": "A"
},
"taxonomies": [
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "IN",
"license": "20043325A",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Indianapolis, IN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 24, 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.