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2850 45th St Ste B Highland IN 46322-2905 | |
| (219) 801-0185 | |
| Not Available |
| Full Name | |
|---|---|
| Speciality | Community/Behavioral Health |
| Location | 2850 45th St Ste B, Highland, Indiana |
| Authorized Official Name and Position | Jill Ann Miller (CLINICAL PSYCHOLOGIST) |
| Authorized Official Contact | 2198010479 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
8521 Northcote Ave Munster IN 46321-2025 Ph: (219) 801-0479 | 2850 45th St Ste B Highland IN 46322-2905 Ph: (219) 801-0185 |
| NPI Number | 1679978563 |
|---|---|
| Provider Enumeration Date | 11/04/2014 |
| Last Update Date | 11/04/2014 |
| Medicare PECOS PAC ID | 2163444704 |
|---|---|
| Medicare Enrollment ID | O20150406000209 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1679978563 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | 20041765A (Indiana) | Primary |
| Provider Name | Jill Ann Miller |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1386665867 PECOS PAC ID: 5698797231 Enrollment ID: I20150406000238 |
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