Individual
PHILIP MATTHEW PROCENTO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PHD
Contact information
Practice address
355 W 16TH ST STE 2800, INDIANAPOLIS, IN 46202-2279
(317) 963-7300
Mailing address
355 W 16TH ST STE 2800, INDIANAPOLIS, IN 46202-2279
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
20043971A
IN
103TC2200X
Clinical Child & Adolescent Psychologist
20043971A
IN
Other
Enumeration date
08/26/2025
Last updated
09/19/2025
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