| Midwest Psychological Center, Inc. | |
|
525 E 38th St Indianapolis IN 46205-2744 | |
| (317) 923-3930 | |
| Not Available |
| Full Name | Midwest Psychological Center, Inc. |
|---|---|
| Speciality | Psychologist |
| Location | 525 E 38th St, Indianapolis, Indiana |
| Authorized Official Name and Position | Shelvy Haywood Keglar (PRESIDENT) |
| Authorized Official Contact | 3179233930 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Midwest Psychological Center, Inc. 525 E 38th St Indianapolis IN 46205-2744 Ph: (317) 923-3930 | Midwest Psychological Center, Inc. 525 E 38th St Indianapolis IN 46205-2744 Ph: (317) 923-3930 |
| NPI Number | 1790922078 |
|---|---|
| Provider Enumeration Date | 01/08/2009 |
| Last Update Date | 05/10/2021 |
| Certification Date | 03/24/2021 |
| Medicare PECOS PAC ID | 6204245905 |
|---|---|
| Medicare Enrollment ID | O20210510002544 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1790922078 | NPI | - | NPPES |
| 000000183364 | Other | IN | ANTHEM |
| 200020330A | Medicaid | IN |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103T00000X | Psychologist | 20040520A (Indiana) | Primary |
| Provider Name | Shelvy H Keglar |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1871642371 PECOS PAC ID: 7911316617 Enrollment ID: I20210510002610 |
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