| Wellhome Psychology, Pc | |
|
15262 W 400 N Medaryville IN 47957-8107 | |
| (219) 804-6262 | |
| (877) 497-6001 |
| Full Name | Wellhome Psychology, Pc |
|---|---|
| Speciality | Social Worker |
| Location | 15262 W 400 N, Medaryville, Indiana |
| Authorized Official Name and Position | Jennifer Dyarman (DIRECTOR) |
| Authorized Official Contact | 2604136994 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Wellhome Psychology, Pc 417 W 81st Ave # 132 Merrillville IN 46410-5317 Ph: (219) 804-6262 | Wellhome Psychology, Pc 15262 W 400 N Medaryville IN 47957-8107 Ph: (219) 804-6262 |
| NPI Number | 1972106599 |
|---|---|
| Provider Enumeration Date | 11/17/2020 |
| Last Update Date | 12/29/2024 |
| Certification Date | 12/29/2024 |
| Medicare PECOS PAC ID | 3476965070 |
|---|---|
| Medicare Enrollment ID | O20201223000380 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1972106599 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 104100000X | Social Worker | (* (Not Available)) | Primary |
| Provider Name | Jennifer Dyarman |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1770873853 PECOS PAC ID: 1951677293 Enrollment ID: I20171101000338 |
| Provider Name | Leah Villavicencio |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1548711294 PECOS PAC ID: 7517310881 Enrollment ID: I20240202001440 |