Healthcare Provider Details

I. General information

NPI: 1487911400
Provider Name (Legal Business Name): RESOLUTIONS PSYCHOLOGICAL SERVICES,LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/15/2012
Last Update Date: 04/15/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5226 S EAST ST SUITE A-5
INDIANAPOLIS IN
46227-1994
US

IV. Provider business mailing address

5226 S EAST ST SUITE A-5
INDIANAPOLIS IN
46227-1994
US

V. Phone/Fax

Practice location:
  • Phone: 317-780-1610
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code103TC2200X
TaxonomyClinical Child & Adolescent Psychologist
License Number20042169A
License Number StateIN
# 2
Primary TaxonomyN
Taxonomy Code103TF0000X
TaxonomyFamily Psychologist
License Number20042169A
License Number StateIN
# 3
Primary TaxonomyY
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License Number20042169A
License Number StateIN

VIII. Authorized Official

Name: ALLISON MCGINLEY
Title or Position: CLINICAL PSYCHOLOGIST/OWNER
Credential:
Phone: 317-780-1610