MEDICARE: DR. JANE ANNE RUSH FORD PSY.D., 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	103TM1800X	Intellectual & Developmental Disabilities Psychologist	20043443A	IN
2	103TC0700X	Clinical Psychologist	20043443A	IN
3	103T00000X	Psychologist

General Provider Information

NPI Number	:	1578693156
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. JANE ANNE RUSH FORD PSY.D., HSPP

Provider Business Mailing Address
First Line	:	6067 DECATUR BLVD
Second Line	:
City	:	INDIANAPOLIS
State	:	IN
Zip	:	46241-9606
Country	:	US
Telephone Number	:	317-455-2366
Fax Number	:

Provider Business Practice Location Address
First Line	:	5715 DECATUR BLVD
Second Line	:
City	:	INDIANAPOLIS
State	:	IN
Zip	:	46241-9561
Country	:	US
Telephone Number	:	317-455-2366
Fax Number	:

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

Provider Enumeration Date	:	03/06/2007
Last Update Date	:	01/07/2026

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