Healthcare Provider Details

I. General information

NPI: 1548334485
Provider Name (Legal Business Name): GREGORY ROBERT KARCH PHD HSPP
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/20/2006
Last Update Date: 03/25/2021
Certification Date: 03/25/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1901 E MAIN ST
RICHMOND IN
47374-5707
US

IV. Provider business mailing address

245 S 4TH ST STE A
RICHMOND IN
47374-5475
US

V. Phone/Fax

Practice location:
  • Phone: 765-935-7284
  • Fax: 765-935-5002
Mailing address:
  • Phone: 765-935-7284
  • Fax: 765-935-5002

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code103TA0400X
TaxonomyAddiction (Substance Use Disorder) Psychologist
License Number20090236A
License Number StateIN
# 2
Primary TaxonomyN
Taxonomy Code103TB0200X
TaxonomyCognitive & Behavioral Psychologist
License Number20090236A
License Number StateIN
# 3
Primary TaxonomyN
Taxonomy Code103TC1900X
TaxonomyCounseling Psychologist
License Number20090236A
License Number StateIN
# 4
Primary TaxonomyN
Taxonomy Code103TF0000X
TaxonomyFamily Psychologist
License Number20090236A
License Number StateIN
# 5
Primary TaxonomyN
Taxonomy Code103TP2701X
TaxonomyGroup Psychotherapy Psychologist
License Number20090236A
License Number StateIN
# 6
Primary TaxonomyY
Taxonomy Code103T00000X
TaxonomyPsychologist
License Number20090236A
License Number StateIN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: