Organization
ST MARGARET MERCY HEALTHCARE CENTERS
Active
Organization
ST MARGARET MERCY HEALTHCARE CENTERS
Active
Other names
St Margaret Mercy Behavioral Health Outpatient Centers
Organization subpart
No
Provider details
NPI number
Authorized official
THOMAS GRYZBEK (PRESIDENT)
(219) 932-2300
Entity
Organization
Contact information
Practice address
5500 HOHMAN AVE, SUITE 3A, HAMMOND, IN 46320-1942
(219) 852-2513
(218) 852-2443
Mailing address
PO BOX 1000, DYER, IN 46311-0800
(219) 864-2107
(219) 864-2251
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
—
—
103TC0700X
Clinical Psychologist
—
—
1041C0700X
Clinical Social Worker
—
—
106H00000X
Marriage & Family Therapist
—
—
207QA0401X
Addiction Medicine (Family Medicine) Physician
—
—
2084P0800X
Psychiatry Physician
Primary
—
—
2084P0804X
Child & Adolescent Psychiatry Physician
—
—
364SP0807X
Child & Adolescent Psychiatric/Mental Health Clinical Nurse Specialist
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100462480I
—
IN
01
—
90000854
BCBSIL
IL
Enumeration date
11/06/2006
Last updated
02/04/2011
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