Organization
MIDWEST PSYCHOLOGICAL CENTER, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. SHELVY HAYWOOD KEGLAR PH.D. (PRESIDENT)
(317) 923-3930
Entity
Organization
Contact information
Practice address
525 E 38TH ST, INDIANAPOLIS, IN 46205-2744
(317) 923-3930
Mailing address
525 E 38TH ST, INDIANAPOLIS, IN 46205-2744
(317) 923-3930
(317) 923-2441
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
20040520A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000183364
ANTHEM
IN
05
—
200020330A
—
IN
Enumeration date
01/08/2009
Last updated
05/10/2021
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