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NPI Code Detail

MEDICARE: JODY HORSTMAN PSYD, HSPP

MEDICARE: JODY HORSTMAN PSYD, HSPP
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
1103TC2200XClinical Child & Adolescent Psychologist20040869IN

Other Identifiers

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

General Provider Information

NPI Number : 1477501716
Entity Type Code : Individual
Provider Name (Legal Business Name) : JODY HORSTMAN PSYD, HSPP
Provider Business Mailing Address
First Line : 9615 E 148TH ST STE 1
Second Line :
City : NOBLESVILLE
State : IN
Zip : 46060-4371
Country : US
Telephone Number : 317-574-1254
Fax Number : 317-674-0060
Provider Business Practice Location Address
First Line : 17840 CUMBERLAND RD
Second Line :
City : NOBLESVILLE
State : IN
Zip : 46060-5409
Country : US
Telephone Number : 317-574-1254
Fax Number : 317-674-0060
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/05/2006
Last Update Date : 02/11/2026

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