| Blackbird Psychological Services | |
|
1901 W Royale Dr Muncie IN 47304-2265 | |
| (765) 393-1008 | |
| Not Available |
| Full Name | Blackbird Psychological Services |
|---|---|
| Speciality | Psychologist |
| Location | 1901 W Royale Dr, Muncie, Indiana |
| Authorized Official Name and Position | Erin Sadler (OWNER/PSYCHOLOGIST) |
| Authorized Official Contact | 7653931008 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Blackbird Psychological Services 1901 W Royale Dr Muncie IN 47304-2265 Ph: (765) 393-1008 | Blackbird Psychological Services 1901 W Royale Dr Muncie IN 47304-2265 Ph: (765) 393-1008 |
| NPI Number | 1548816010 |
|---|---|
| Provider Enumeration Date | 08/12/2019 |
| Last Update Date | 06/29/2023 |
| Certification Date | 06/29/2023 |
| Medicare PECOS PAC ID | 4688090798 |
|---|---|
| Medicare Enrollment ID | O20200820000440 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1548816010 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103TC0700X | Psychologist - Clinical | (* (Not Available)) | Primary |
| Provider Name | Jodi L Nixon |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1417953670 PECOS PAC ID: 2567415789 Enrollment ID: I20050301000116 |
| Provider Name | Erin Sadler |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1376066050 PECOS PAC ID: 7517219546 Enrollment ID: I20181002003275 |
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