| Dr Kellie Cooper, LP, HSPP | |
|
3010 E State Blvd, Fort Wayne, IN 46805-4700 | |
| (260) 471-2300 | |
| Not Available |
| Full Name | Dr Kellie Cooper |
|---|---|
| Gender | Female |
| Speciality | Clinical Psychologist |
| Experience | 2 Years |
| Location | 3010 E State Blvd, Fort Wayne, Indiana |
| Accepts Medicare Assignments | Yes. She accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1316437205 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103T00000X | Psychologist | 20043895 (Indiana) | Secondary |
| 103TC0700X | Psychologist - Clinical | 6301016322 (Michigan) | Primary |
| Group Practice Name | Group PECOS PAC ID | No. of Members |
|---|---|---|
| Center For Neurobehavioral Services Inc | 3072544584 | 5 |
| Entity Name | Center for Neurobehavioral Services Inc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1548275258 PECOS PAC ID: 3072544584 Enrollment ID: O20050824000934 |
| Mailing Address | Practice Location Address |
|---|---|
| Dr Kellie Cooper, LP, HSPP 3010 E State Blvd, Fort Wayne, IN 46805-4700 Ph: Not Available | Dr Kellie Cooper, LP, HSPP 3010 E State Blvd, Fort Wayne, IN 46805-4700 Ph: (260) 471-2300 |
Ms. Shauna Marie Croarkin, ED.S., NCSP Psychologist Medicare: Not Enrolled in Medicare Practice Location: 1200 Barr St, Fort Wayne, IN 46802 Phone: 260-467-1124 Fax: 260-467-1188 |
Dr. Michelle Renne Miller, PH.D. Psychologist Medicare: Not Enrolled in Medicare Practice Location: 4630 W Jefferson Blvd, Ste 11a, Fort Wayne, IN 46804 Phone: 260-434-1606 Fax: 260-434-1612 |
Dr. Victor L Rebman, PH.D. Psychologist Medicare: Not Enrolled in Medicare Practice Location: 1910 Saint Joe Center Rd, Office #63, Fort Wayne, IN 46825 Phone: 260-471-9902 Fax: 260-471-9902 |
Michele Lynn Grimm, Psychologist Medicare: Not Enrolled in Medicare Practice Location: 1200 S Clinton St, Fort Wayne, IN 46802 Phone: 260-467-1150 Fax: 260-467-1188 |
Jason T. Cook, PSY.D., HSPP Psychologist Medicare: Accepting Medicare Assignments Practice Location: 7230 Engle Rd, Ste 304, Fort Wayne, IN 46804 Phone: 260-483-2400 Fax: 260-960-9361 |
Dr. Galen Arthur Yordy, PHD Psychologist Medicare: Not Enrolled in Medicare Practice Location: 2805 Fairfield Ave, Fort Wayne, IN 46807 Phone: 260-456-4880 Fax: 260-456-3559 |
Dr. Kelly Stewart Hutner, PSY.D., HSPP Psychologist Medicare: Accepting Medicare Assignments Practice Location: 11143 Parkview Plaza Dr Ste 320, Fort Wayne, IN 46845 Phone: 260-266-5370 Fax: 260-266-5379 |