Powers Psychological Services Llc | |
10311 Dawsons Creek Blvd Suite F Fort Wayne IN 46825-1913 | |
(260) 490-5800 | |
(260) 490-8722 |
Full Name | Powers Psychological Services Llc |
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Speciality | Psychologist |
Location | 10311 Dawsons Creek Blvd, Fort Wayne, Indiana |
Authorized Official Name and Position | Abigail Dormire Powers (PSYCHOLOGIST) |
Authorized Official Contact | 2604905800 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
---|---|
Powers Psychological Services Llc 10311 Dawsons Creek Blvd Suite F Fort Wayne IN 46825-1913 Ph: (260) 490-5800 | Powers Psychological Services Llc 10311 Dawsons Creek Blvd Suite F Fort Wayne IN 46825-1913 Ph: (260) 490-5800 |
NPI Number | 1912121070 |
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Provider Enumeration Date | 04/12/2007 |
Last Update Date | 08/22/2020 |
Medicare PECOS PAC ID | 2163519687 |
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Medicare Enrollment ID | O20071031000368 |
Identifier | Type | State | Issuer |
---|---|---|---|
1912121070 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
103TC0700X | Psychologist - Clinical | 20040449A (Indiana) | Primary |
Provider Name | Abigail D Powers |
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Provider Type | Practitioner - Clinical Psychologist |
Provider Identifiers | NPI Number: 1912080359 PECOS PAC ID: 9931204344 Enrollment ID: I20071030000336 |
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