| Cpd3, Inc. | |
|
2205 N Wheeling Ave Muncie IN 47303-1602 | |
| (765) 287-1922 | |
| (765) 287-9017 |
| Full Name | Cpd3, Inc. |
|---|---|
| Speciality | Counselor |
| Location | 2205 N Wheeling Ave, Muncie, Indiana |
| Authorized Official Name and Position | Tammy Lampke (OWNER/MANAGER) |
| Authorized Official Contact | 7652871922 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Cpd3, Inc. 2205 N Wheeling Ave Muncie IN 47303-1602 Ph: (765) 287-1922 | Cpd3, Inc. 2205 N Wheeling Ave Muncie IN 47303-1602 Ph: (765) 287-1922 |
| NPI Number | 1821634460 |
|---|---|
| Provider Enumeration Date | 11/19/2019 |
| Last Update Date | 11/19/2019 |
| Medicare PECOS PAC ID | 2264860071 |
|---|---|
| Medicare Enrollment ID | O20200310000323 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1821634460 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YM0800X | Counselor - Mental Health | (* (Not Available)) | Primary |
| Provider Name | Sharon J Ezop |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1790855427 PECOS PAC ID: 6002892213 Enrollment ID: I20040628001348 |
| Provider Name | Jamie Lynne Bergan |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1922403807 PECOS PAC ID: 2769708973 Enrollment ID: I20150306000298 |
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