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General NPI Number Information
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NPI Number | 1043029861
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Entity Type | Organization
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Legal Business Name | SOMMER PSYCHOLOGY GROUP
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Dates
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Enumeration Date | 01/06/2025
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Last Update Date | 01/06/2025
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Provider Practice Location Address
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Address Line | 69 N WHITTIER PL
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City | INDIANAPOLIS
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State | IN
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Zip | 46219-5713
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Country | US
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Telephone | 812-320-6652
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Fax |
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Provider Business Mailing Address
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Address Line | 8465 KEYSTONE XING STE 115 #752
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City | INDIANAPOLIS
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State | IN
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Zip | 46240-2453
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Country | US
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Telephone | 317-520-8338
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Fax |
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Authorized Official
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Title or Position | MEMBER/DIRECTOR OF OPERATION
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Name | SAMUEL A BURNS
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Credential |
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Telephone | 317-627-8154
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103TP2701X
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Taxonomy Name | Group Psychotherapy Psychologist
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License Number |
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License Number State |
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