MEDICARE: CRAIN PSYCHOLOGICAL SPECIALISTS, LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	103TC0700X	Clinical Psychologist

General Provider Information

NPI Number	:	1881440329
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CRAIN PSYCHOLOGICAL SPECIALISTS, LLC

Provider Business Mailing Address
First Line	:	8645 RAHKE RD
Second Line	:
City	:	INDIANAPOLIS
State	:	IN
Zip	:	46217-5084
Country	:	US
Telephone Number	:	317-296-2754
Fax Number	:	317-780-5755

Provider Business Practice Location Address
First Line	:	6411 S EAST ST STE A
Second Line	:
City	:	INDIANAPOLIS
State	:	IN
Zip	:	46227-2737
Country	:	US
Telephone Number	:	317-296-2754
Fax Number	:	317-780-5755

Authorized Official
Title or Position	:	CLINICAL PSYCHOLOGIST
Name	:	DR. ROBBI CRAIN
Credential	:	PSYD
Telephone Number	:	317-296-2754

Provider Enumeration Date	:	04/25/2024
Last Update Date	:	04/25/2024

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