Healthcare Provider Details

I. General information

NPI: 1972988020
Provider Name (Legal Business Name): MARY FAYE FIELDS PSY.D, LP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: MARY FAYE COLLINS LP, PSY.D

II. Dates (important events)

Enumeration Date: 07/29/2015
Last Update Date: 10/27/2025
Certification Date: 10/27/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2535 NORTH 200 EAST
ANGOLA IN
46737
US

IV. Provider business mailing address

245 LANE 650B SNOW LK
FREMONT IN
46737-9006
US

V. Phone/Fax

Practice location:
  • Phone: 260-705-5507
  • Fax:
Mailing address:
  • Phone: 260-705-5507
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code103T00000X
TaxonomyPsychologist
License Number5755
License Number StateNC
# 2
Primary TaxonomyN
Taxonomy Code103T00000X
TaxonomyPsychologist
License NumberPSY.0006894
License Number StateCO
# 3
Primary TaxonomyN
Taxonomy Code103T00000X
TaxonomyPsychologist
License NumberPSY-2025-0129
License Number StateNM
# 4
Primary TaxonomyN
Taxonomy Code103T00000X
TaxonomyPsychologist
License Number20043864A
License Number StateIN
# 5
Primary TaxonomyY
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License Number0810006368
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: