Organization
LIVING WELL BEHAVIORAL HEALTH, PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JONATHAN NEUFELD PH.D. (PRESIDENT)
(574) 534-6150
Entity
Organization
Contact information
Practice address
1908 W LINCOLN AVE, GOSHEN, IN 46526-5907
(574) 534-6150
(574) 534-8139
Mailing address
1908 W LINCOLN AVE, GOSHEN, IN 46526-5907
(574) 534-6150
(574) 534-8139
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
20042056A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200804500A
—
IN
05
—
200888680
—
IN
Enumeration date
09/15/2006
Last updated
08/27/2008
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