| Dynamic Psychology, Llc | |
|
619 Franklin St Ste 203 Michigan City IN 46360-3411 | |
| (219) 561-0168 | |
| (219) 666-6092 |
| Full Name | Dynamic Psychology, Llc |
|---|---|
| Speciality | Psychologist |
| Location | 619 Franklin St Ste 203, Michigan City, Indiana |
| Authorized Official Name and Position | Kathryn F Zeckel (OWNER CLINICIAN) |
| Authorized Official Contact | 2195610168 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Dynamic Psychology, Llc 432 St John Rd # 100 Michigan City IN 46360-7336 Ph: (219) 561-0168 | Dynamic Psychology, Llc 619 Franklin St Ste 203 Michigan City IN 46360-3411 Ph: (219) 561-0168 |
| NPI Number | 1477159622 |
|---|---|
| Provider Enumeration Date | 12/11/2020 |
| Last Update Date | 03/09/2022 |
| Certification Date | 03/09/2022 |
| Medicare PECOS PAC ID | 8820401433 |
|---|---|
| Medicare Enrollment ID | O20201228001339 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1477159622 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103TH0100X | Psychologist - Health Service | (* (Not Available)) | Primary |
| 261QM0850X | Clinic/center - Adult Mental Health | (* (Not Available)) | Secondary |
| Provider Name | Kathryn F Zeckel |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1679079420 PECOS PAC ID: 5395098925 Enrollment ID: I20181030000762 |
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