Individual
EDWARD GURAUSKAS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
HSPP
Contact information
Practice address
8555 TAFT ST, MERRILLVILLE, IN 46410-6123
(219) 769-4005
(219) 769-2508
Mailing address
8400 LOUISIANA ST, MERRILLVILLE, IN 46410-6385
(219) 757-1928
(219) 757-1950
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
20040492A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000202004
ANTHEM BCBS
IN
05
—
100342740A
—
IN
Enumeration date
08/31/2005
Last updated
05/25/2011
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