Is this information incorrect? This page shows public data from NPPES. Update your record in NPPES and this page will update automatically within 7 days.
Organization
FAMILY PSYCHOLOGY OF SOUTH BEND LLC
Active
Organization
FAMILY PSYCHOLOGY OF SOUTH BEND LLC
Active
Other names
Family Psychology of South Bend
Organization subpart
No
Provider details
NPI number
Authorized official
JOHN ANTHONY PETERSEN PSYD (MANAGER)
(574) 280-8199
Entity
Organization
Contact information
Practice address
922 E WAYNE ST STE 205, SOUTH BEND, IN 46617-3024
(574) 280-8199
Mailing address
922 E WAYNE ST STE 205, SOUTH BEND, IN 46617-3024
(574) 280-8199
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
—
—
103TC0700X
Clinical Psychologist
—
—
103TF0000X
Family Psychologist
Primary
—
—
1041C0700X
Clinical Social Worker
—
—
Other
Enumeration date
12/01/2018
Last updated
12/01/2018
About Stedi
Stedi is the only programmable healthcare clearinghouse. You can use Stedi's APIs to process eligibility checks, claims, remits, and more.
Sign up