Integritas Psychological Services Inc.

Primary specialty

Health Service PsychologistTaxonomy code 103TH0100X

License

20042547A Issued in IN

Legal business name

INTEGRITAS PSYCHOLOGICAL SERVICES INC.

Practice address

6239 S East St
Suite E
Indianapolis, IN 46227-2090

Phone

(317) 455-6780

NPI assigned

Oct 3, 2011

Organization subpart

No

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

Authorized official

Name

Eric M Gudan, PSY.D.NPI 1861624736

Title

Psychologist

Phone

(317) 455-6782

Specialties & licenses 2

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in IN

Enrollment records 1

Locations

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Eric M Gudan, PSYD

  • Clinical Psychologist
  • Indianapolis, IN
  • NPI 1861624736
  Medicare reassignment NPD Authorized official
• Dan Christian Fernando

  • Mental Health Counselor
  • Indianapolis, IN
  • NPI 1649109067
  NPD (past)

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

{
    "created_epoch": "1317600000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1586908800000",
    "number": "1972887479",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "910 N SHADELAND AVE STE 1",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462194810",
            "telephone_number": "317-455-6780"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6239 S EAST ST",
            "address_2": "SUITE E",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462272090",
            "telephone_number": "317-455-6780"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "INTEGRITAS PSYCHOLOGICAL SERVICES INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-10-03",
        "last_updated": "2020-04-15",
        "certification_date": "2020-04-15",
        "status": "A",
        "authorized_official_last_name": "GUDAN",
        "authorized_official_first_name": "ERIC",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "PSYCHOLOGIST",
        "authorized_official_telephone_number": "317-455-6782",
        "authorized_official_credential": "PSY.D."
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Psychologist, Clinical",
            "state": "IN",
            "license": "20042547A",
            "primary": false
        },
        {
            "code": "103TH0100X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Psychologist, Health Service",
            "state": "IN",
            "license": "20042547A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "ips.carepaths.com",
            "affiliation": "N",
            "address_1": "910 N Shadeland Ave",
            "city": "Indianapolis",
            "state": "IN",
            "country_code": "US",
            "postal_code": "462194810",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

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• Health Service Psychologist in Indianapolis, IN
• Providers in Indianapolis, IN by specialty
• Health Service Psychologist in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 15, 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.