MEDICARE: CLINICAL PSYCHOLOGICAL ASSESSMENT & CONSULTING, PC

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
1	103TC0700X	Clinical Psychologist	57000116A	IN
2	103TH0100X	Health Service Psychologist	57000116A	IN

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
9	DE0072	OTHER	GA	MEDICARE RAILROAD CARRIER

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	000000381792	OTHER	IN	ANTHEM BCBS
2	064755	OTHER	IN	SIHO
3	258751	OTHER	IL	COMPSYCH
4	0393476	OTHER	UT	UNITED HEALTHCARE
5	82272400	OTHER	OH	MAGELLAN
6	000000381784	OTHER	OH	ANTHEM BCBS
7	7627650	OTHER	CT	AETNA
8	C 231810	OTHER	TX	UNITED AMERICAN INSURANCE

General Provider Information

NPI Number	:	1457332710
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CLINICAL PSYCHOLOGICAL ASSESSMENT & CONSULTING, PC

Provider Business Mailing Address
First Line	:	139 S EAST ST
Second Line	:	PO BOX 7
City	:	CROTHERSVILLE
State	:	IN
Zip	:	47229-9635
Country	:	US
Telephone Number	:	812-793-2570
Fax Number	:	812-793-2570

Provider Business Practice Location Address
First Line	:	139 S EAST ST
Second Line	:
City	:	CROTHERSVILLE
State	:	IN
Zip	:	47229-9635
Country	:	US
Telephone Number	:	812-793-2570
Fax Number	:	812-793-2570

Authorized Official
Title or Position	:	PRES, OWNER, CLINICAL PSYCHOLOGIST
Name	:	DR. STEPHANIE L SCIFRES
Credential	:	PHD, HSPP
Telephone Number	:	812-793-2570

Provider Enumeration Date	:	11/14/2005
Last Update Date	:	09/11/2025

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