| Clinical Psychology Center, P.c. | |
|
15 N Franklin St Suite 230 Valparaiso IN 46383 | |
| (219) 462-4770 | |
| (219) 464-8156 |
| Full Name | Clinical Psychology Center, P.c. |
|---|---|
| Speciality | Psychologist |
| Location | 15 N Franklin St, Valparaiso, Indiana |
| Authorized Official Name and Position | Daniel L. Schultz (PRESIDENT) |
| Authorized Official Contact | 2194624770 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Clinical Psychology Center, P.c. 15 N Franklin St Suite 230 Valparaiso IN 46383 Ph: (219) 462-4770 | Clinical Psychology Center, P.c. 15 N Franklin St Suite 230 Valparaiso IN 46383 Ph: (219) 462-4770 |
| NPI Number | 1821184110 |
|---|---|
| Provider Enumeration Date | 10/05/2006 |
| Last Update Date | 07/01/2011 |
| Medicare PECOS PAC ID | 3971565979 |
|---|---|
| Medicare Enrollment ID | O20050413001277 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1821184110 | NPI | - | NPPES |
| 200023980 | Medicaid | IN |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103TC0700X | Psychologist - Clinical | 20010329A (Indiana) | Secondary |
| 103TC0700X | Psychologist - Clinical | (Indiana) | Primary |
| Provider Name | Daniel L Schultz |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1356347710 PECOS PAC ID: 7416919428 Enrollment ID: I20110330000025 |
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