Organization
CLINICAL PSYCHOLOGY ASSOCIATES, PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KATHLEEN M PUESCHEL PH.D. (PRESIDENT)
(219) 736-0003
Entity
Organization
Contact information
Practice address
9111 BROADWAY, SUITE Q, MERRILLVILLE, IN 46410
(219) 736-0003
(219) 756-2315
Mailing address
PO BOX 10126, MERRILLVILLE, IN 46411-0126
(219) 736-0003
(219) 756-2315
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100389940
—
IN
05
—
100389940A
—
IN
Enumeration date
11/06/2006
Last updated
12/19/2014
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