Individual provider Active NPI

Taylor Kathleen Locker, PH.D.

  • Clinical Psychologist
  • West Lafayette, IN
National Provider Identifier
1982015764
Registry record updated Sep 1, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
20043054A Issued in IN
Practice address
480 W Navajo St Ste B
West Lafayette, IN 47906-1940
Phone
(765) 637-9200
Fax
(765) 637-9202
NPI assigned
May 14, 2014
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 1, 2023

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

Specialties & licenses 6

Specialty (taxonomy)CodeLicenseStatePrimary
Psychologist 103T00000X 073687 IA
Psychologist 103T00000X 20043054A IN
Counseling Psychologist 103TC1900X
Health Service Psychologist 103TH0100X IN
Group Psychotherapy Psychologist 103TP2701X
Clinical Psychologist 103TC0700X 20043054A IN Primary

Addresses

Primary practice location

480 W Navajo St Ste B
West Lafayette, IN 47906-1940

Mailing address

480 W Navajo St Ste B
West Lafayette, IN 47906-1940
Phone (765) 637-9200

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IN
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20170921001953 IN Practitioner - Clinical Psychologist 2769756212 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Locker Psychological Services, LLCGroup PAC ID 1850665308, 2 clinicians

Practice addresses (Care Compare)

480 W Navajo St
Suite B
West Lafayette, IN 47906-1940
Phone (765) 637-9200

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
073687IAMDPsychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Locker Psychological Services, LLC Psychologist CurrentSince Aug 10, 2017 Accepting new patients

Locations

678B N 36th St
Lafayette, IN 47905
Phone (765) 237-9536

480 W Navajo St
#B
West Lafayette, IN 47906
Phone (765) 463-1370

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.

NPI Registry JSON

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

{
    "created_epoch": "1400025600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1693526400000",
    "number": "1982015764",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "480 W NAVAJO ST STE B",
            "city": "WEST LAFAYETTE",
            "state": "IN",
            "postal_code": "479061940",
            "telephone_number": "765-637-9200",
            "fax_number": "765-637-9202"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "480 W NAVAJO ST STE B",
            "city": "WEST LAFAYETTE",
            "state": "IN",
            "postal_code": "479061940",
            "telephone_number": "765-637-9200",
            "fax_number": "765-637-9202"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LOCKER",
        "first_name": "TAYLOR",
        "middle_name": "KATHLEEN",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-05-14",
        "last_updated": "2023-09-01",
        "certification_date": "2023-09-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "IA",
            "license": "073687",
            "primary": false
        },
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "IN",
            "license": "20043054A",
            "primary": false
        },
        {
            "code": "103TC1900X",
            "taxonomy_group": "",
            "desc": "Psychologist, Counseling",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "103TH0100X",
            "taxonomy_group": "",
            "desc": "Psychologist, Health Service",
            "state": "IN",
            "license": null,
            "primary": false
        },
        {
            "code": "103TP2701X",
            "taxonomy_group": "",
            "desc": "Psychologist, Group Psychotherapy",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "IN",
            "license": "20043054A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in West Lafayette, IN

Sources for this page

Verify at the official NPI Registry.