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NPI Code Detail

MEDICARE: MODERN STRENGTH PSYCHOLOGY CENTER

MEDICARE: MODERN STRENGTH PSYCHOLOGY CENTER
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1103T00000XPsychologist

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1255039079
Entity Type Code : Organization
Provider Name (Legal Business Name) : MODERN STRENGTH PSYCHOLOGY CENTER
Provider Business Mailing Address
First Line : 9102 N MERIDIAN ST STE 550
Second Line :
City : INDIANAPOLIS
State : IN
Zip : 46260-1899
Country : US
Telephone Number : 317-559-3221
Fax Number :
Provider Business Practice Location Address
First Line : 9102 N MERIDIAN ST STE 550
Second Line :
City : INDIANAPOLIS
State : IN
Zip : 46260-1899
Country : US
Telephone Number : 614-448-6693
Fax Number :
Authorized Official
Title or Position : OWNER, CLINICAL NEUROPSYCHOLOGIST
Name : DR. KASSANDRA E LOWERY
Credential : PH.D.
Telephone Number : 317-559-3221
Provider Enumeration Date : 02/21/2023
Last Update Date : 09/22/2023

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Directions to “MODERN STRENGTH PSYCHOLOGY CENTER ” Practice Location

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