Alyssa Marie Kregloh, PSYD, HSPP | |
1600 W Main St, Lebanon, IN 46052-2388 | |
(317) 574-1254 | |
(317) 674-0060 |
Full Name | Alyssa Marie Kregloh |
---|---|
Gender | Female |
Speciality | Psychologist |
Location | 1600 W Main St, Lebanon, Indiana |
Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1528512134 | NPI | - | NPPES |
20043246A | Other | IN | PSYCHOLOGIST LICENSE |
20043246B | Other | IN | HEALTH SERVICE PROVIDER IN PSYCHOLOGY (HSPP) |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
103T00000X | Psychologist | 20043246A (Indiana) | Primary |
101YM0800X | Counselor - Mental Health | (Indiana) | Secondary |
Entity Name | Aspire Indiana Inc |
---|---|
Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1124016050 PECOS PAC ID: 4486635455 Enrollment ID: O20041015000190 |
Entity Name | Aspire Indiana Health Inc |
---|---|
Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1780068288 PECOS PAC ID: 8921314196 Enrollment ID: O20150902001749 |
Mailing Address | Practice Location Address |
---|---|
Alyssa Marie Kregloh, PSYD, HSPP 9615 E 148th St Ste 1, Noblesville, IN 46060-4371 Ph: (317) 574-1254 | Alyssa Marie Kregloh, PSYD, HSPP 1600 W Main St, Lebanon, IN 46052-2388 Ph: (317) 574-1254 |
Mr. Eitan M Gordon, ED.S. Psychologist Medicare: Not Enrolled in Medicare Practice Location: 1810 N Grant St, Lebanon, IN 46052 Phone: 773-742-2487 | |
Abigail Gliva, Psychologist Medicare: Not Enrolled in Medicare Practice Location: 125 Lakeshore Dr, Lebanon, IN 46052 Phone: 765-483-3090 |