| Northside Psychotherapy Services, Llc | |
|
921 E 86th St Suite 210 Indianapolis IN 46240-1859 | |
| (317) 202-0801 | |
| (317) 253-8767 |
| Full Name | Northside Psychotherapy Services, Llc |
|---|---|
| Speciality | Clinic/center |
| Location | 921 E 86th St, Indianapolis, Indiana |
| Authorized Official Name and Position | April S. Katherine Lynch (OWNER) |
| Authorized Official Contact | 3172020801 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Northside Psychotherapy Services, Llc 921 E 86th St Suite 210 Indianapolis IN 46240-1841 Ph: (317) 202-0801 | Northside Psychotherapy Services, Llc 921 E 86th St Suite 210 Indianapolis IN 46240-1859 Ph: (317) 202-0801 |
| NPI Number | 1407999543 |
|---|---|
| Provider Enumeration Date | 02/15/2007 |
| Last Update Date | 08/19/2008 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1407999543 | NPI | - | NPPES |
| 200532630A | Medicaid | IN |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261Q00000X | Clinic/center | 39001711A (Indiana) | Primary |
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