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NPI Code Detail

MEDICARE: YWCA NORTH CENTRAL INDIANA

MEDICARE: YWCA NORTH CENTRAL INDIANA
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
1251S00000XCommunity/Behavioral Health AgencyIN

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 : 1811365604
Entity Type Code : Organization
Provider Name (Legal Business Name) : YWCA NORTH CENTRAL INDIANA
Provider Business Mailing Address
First Line : 1102 S. FELLOWS ST.
Second Line :
City : SOUTH BEND
State : IN
Zip : 46601-3514
Country : US
Telephone Number : 574-233-9491
Fax Number : 574-233-9616
Provider Business Practice Location Address
First Line : 1102 FELLOWS ST
Second Line :
City : SOUTH BEND
State : IN
Zip : 46601-3514
Country : US
Telephone Number : 574-233-9491
Fax Number : 574-233-9616
Authorized Official
Title or Position : HEALTH SERVICE PROVIDER PSYCHOLOGY
Name : DR. SHARON DEVINNEY
Credential : PH.D.
Telephone Number : 574-286-0055
Provider Enumeration Date : 09/10/2015
Last Update Date : 09/10/2015

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Directions to “YWCA NORTH CENTRAL INDIANA ” Practice Location

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