| The Hope Source Inc. | |
|
8350 Craig St Indianapolis IN 46250-3593 | |
| (317) 578-0410 | |
| (317) 436-7409 |
| Full Name | The Hope Source Inc. |
|---|---|
| Speciality | Clinic/Center |
| Location | 8350 Craig St, Indianapolis, Indiana |
| Authorized Official Name and Position | Momi Yamanaka (EXECUTIVE CLINICAL DIRECTOR) |
| Authorized Official Contact | 3175178817 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| The Hope Source Inc. 8350 Craig St Indianapolis IN 46250-3593 Ph: (317) 578-0410 | The Hope Source Inc. 8350 Craig St Indianapolis IN 46250-3593 Ph: (317) 578-0410 |
| NPI Number | 1265736615 |
|---|---|
| Provider Enumeration Date | 12/28/2010 |
| Last Update Date | 12/06/2024 |
| Certification Date | 12/06/2024 |
| Medicare PECOS PAC ID | 7810422409 |
|---|---|
| Medicare Enrollment ID | O20241119003036 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1265736615 | NPI | - | NPPES |
| Provider Name | Momi Yamanaka |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1952494411 PECOS PAC ID: 9032277843 Enrollment ID: I20100201000599 |
| Provider Name | Julie Brant Gordon |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1528362985 PECOS PAC ID: 9638604226 Enrollment ID: I20241119003210 |
| Provider Name | Lisa Rivka Minor |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1912348764 PECOS PAC ID: 6406381003 Enrollment ID: I20241119003826 |
| Provider Name | Roberto Morales |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1548245756 PECOS PAC ID: 3375521230 Enrollment ID: I20241120001088 |
| Provider Name | Rachel Leffel |
|---|---|
| Provider Type | Practitioner - Qualified Speech Language Pathologist |
| Provider Identifiers | NPI Number: 1265093231 PECOS PAC ID: 9739614306 Enrollment ID: I20241120001706 |
| Provider Name | Rebecca Hammond |
|---|---|
| Provider Type | Practitioner - Occupational Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1588418842 PECOS PAC ID: 3173059821 Enrollment ID: I20241205001295 |
| Provider Name | Kasey Suzanne Kanger |
|---|---|
| Provider Type | Practitioner - Qualified Speech Language Pathologist |
| Provider Identifiers | NPI Number: 1770896664 PECOS PAC ID: 9234665993 Enrollment ID: I20241205001440 |
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