Individual
JEFFREY SAMELSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PHD
Contact information
Practice address
104 WOODLAND CT STE B, MICHIGAN CITY, IN 46360-7391
(219) 628-6463
(219) 628-6463
Mailing address
1225 E COOLSPRING AVE, MICHIGAN CITY, IN 46360-6312
(219) 873-2964
(219) 873-2933
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
20010303A
IN
103TC0700X
Clinical Psychologist
Primary
20010303A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000347073
ANTHEM
IN
05
—
100162900
—
IN
01
—
P00616032
RR MEDICARE
—
Enumeration date
01/26/2006
Last updated
03/07/2024
About Stedi
Stedi is the only programmable healthcare clearinghouse. You can use Stedi's APIs to process eligibility checks, claims, remits, and more.
Contact us