MEDICARE: DR. RICHARD J GALE 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
1	103T00000X	Psychologist	20042697A	IN

General Provider Information

NPI Number	:	1538475199
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. RICHARD J GALE PSYD, HSPP

Provider Business Mailing Address
First Line	:	5124 REFORMATORY RD
Second Line	:
City	:	PENDLETON
State	:	IN
Zip	:	46064-8767
Country	:	US
Telephone Number	:	765-778-8011
Fax Number	:

Provider Business Practice Location Address
First Line	:	6437 RUCKER RD STE C
Second Line	:
City	:	INDIANAPOLIS
State	:	IN
Zip	:	46220-4868
Country	:	US
Telephone Number	:	317-426-6318
Fax Number	:	317-516-0924

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/20/2010
Last Update Date	:	08/13/2024

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