Healthcare Provider Details

I. General information

NPI: 1437079621
Provider Name (Legal Business Name): JOSEPH W. KOVACH PSYD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/17/2026
Last Update Date: 07/17/2026
Certification Date: 07/17/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1426 OAK PARK DR
MUNSTER IN
46321-2622
US

IV. Provider business mailing address

1426 OAK PARK DR
MUNSTER IN
46321-2622
US

V. Phone/Fax

Practice location:
  • Phone: 219-838-3338
  • Fax:
Mailing address:
  • Phone: 219-838-3338
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101Y00000X
TaxonomyCounselor
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code103TS0200X
TaxonomySchool Psychologist
License Number431726
License Number StateIL
# 3
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number35000873A
License Number StateIN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: