Healthcare Provider Details

I. General information

NPI: 1861505059
Provider Name (Legal Business Name): ARTHUR KUPERSMITH PHD., HSPP
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/15/2006
Last Update Date: 01/28/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

101 S WASHINGTON ST
MARION IN
46952-3867
US

IV. Provider business mailing address

101 S WASHINGTON ST
MARION IN
46952-3867
US

V. Phone/Fax

Practice location:
  • Phone: 765-662-9971
  • Fax: 765-651-6556
Mailing address:
  • Phone: 765-662-9971
  • Fax: 765-651-6556

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code103TH0100X
TaxonomyHealth Service Psychologist
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code103T00000X
TaxonomyPsychologist
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License NumberLIC20090165A
License Number StateIN
# 4
Primary TaxonomyN
Taxonomy Code103TC1900X
TaxonomyCounseling Psychologist
License NumberLIC20090165A
License Number StateIN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: