Brain Performance Llc | |
3003 E. 98th Street Suite # 107 Indianapolis IN 46280 | |
(463) 273-2093 | |
(317) 672-1971 |
Full Name | Brain Performance Llc |
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Speciality | Psychologist |
Location | 3003 E. 98th Street, Indianapolis, Indiana |
Authorized Official Name and Position | James Sorgi (OWNER) |
Authorized Official Contact | 3174418499 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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Brain Performance Llc 3003 E. 98th Street Suite # 107 Indianapolis IN 46280 Ph: (463) 273-2093 | Brain Performance Llc 3003 E. 98th Street Suite # 107 Indianapolis IN 46280 Ph: (463) 273-2093 |
NPI Number | 1013319656 |
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Provider Enumeration Date | 09/25/2014 |
Last Update Date | 02/05/2024 |
Medicare PECOS PAC ID | 3274755814 |
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Medicare Enrollment ID | O20141114000146 |
Identifier | Type | State | Issuer |
---|---|---|---|
1013319656 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
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103TF0200X | Psychologist - Forensic | (* (Not Available)) | Primary |
1041C0700X | Social Worker - Clinical | (* (Not Available)) | Secondary |
Provider Name | Corby A Bubp |
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Provider Type | Practitioner - Clinical Psychologist |
Provider Identifiers | NPI Number: 1134136229 PECOS PAC ID: 6002872694 Enrollment ID: I20041206000556 |
Provider Name | Mitchell James Vansumeren |
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Provider Type | Practitioner - Clinical Psychologist |
Provider Identifiers | NPI Number: 1023534815 PECOS PAC ID: 7810229051 Enrollment ID: I20191021003388 |
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