Individual
DR. JINGER ATTEBERRY-BENNETT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PH.D., HSPP
Contact information
Practice address
10293 N MERIDIAN ST, SUITE 180, INDIANAPOLIS, IN 46290-1123
(317) 582-1203
(317) 853-1314
Mailing address
10291 N MERIDIAN ST, SUITE 160, INDIANAPOLIS, IN 46290-1076
(317) 582-1203
(317) 853-1314
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
20040292A
IN
103TC0700X
Clinical Psychologist
20040292A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000182359
ANTHEM PROVIDER I.D. NO.
IN
01
—
000000182361
ANTHEM PROVIDER I.D. NO.
IN
01
—
063867
VALUE OPTIONS I.D. NO.
IN
05
—
100120710A
—
IN
01
—
10022395
ENCORE PPO ONE I.D.
IN
Enumeration date
01/03/2007
Last updated
04/28/2017
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