Organization
MID-AMERICA PSYCHOLOGICAL & COUNSELING SERVICE P.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KALYANI GOPAL PH.D (PRESIDENT)
(219) 736-1000
Entity
Organization
Contact information
Practice address
7725 BROADWAY, STE A, MERRILLVILLE, IN 46410-4728
(219) 736-1000
(219) 736-9699
Mailing address
7725 BROADWAY, STE A, MERRILLVILLE, IN 46410-4728
(219) 736-1000
(219) 736-9699
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
20041200A
IN
Other
Enumeration date
06/13/2007
Last updated
02/21/2018
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