| Modern Mental Health | |
|
1330 Win Hentschel Blvd West Lafayette IN 47906-4149 | |
| (765) 444-3999 | |
| Not Available |
| Full Name | Modern Mental Health |
|---|---|
| Speciality | Psychologist |
| Location | 1330 Win Hentschel Blvd, West Lafayette, Indiana |
| Authorized Official Name and Position | Amanda Lyn Mckinney (DIRECTOR) |
| Authorized Official Contact | 7654443999 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Modern Mental Health 1330 Win Hentschel Blvd Ste 202 West Lafayette IN 47906-4149 Ph: (765) 444-3999 | Modern Mental Health 1330 Win Hentschel Blvd West Lafayette IN 47906-4149 Ph: (765) 444-3999 |
| NPI Number | 1740741750 |
|---|---|
| Provider Enumeration Date | 03/31/2019 |
| Last Update Date | 02/07/2024 |
| Certification Date | 02/07/2024 |
| Medicare PECOS PAC ID | 5799139580 |
|---|---|
| Medicare Enrollment ID | O20230927003577 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1740741750 | NPI | - | NPPES |
| Provider Name | Kelly S Earnst |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1104900489 PECOS PAC ID: 7012182819 Enrollment ID: I20111206000471 |
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