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1821124801

NPI Code Detail

MEDICARE: MERIDIAN PSYCHOLOGICAL ASSOCIATES,P.C.

MEDICARE: MERIDIAN PSYCHOLOGICAL ASSOCIATES,P.C.

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	101YM0800X	Mental Health Counselor	57000016A	IN
2	103T00000X	Psychologist	57000016A	IN
3	103TF0200X	Forensic Psychologist	57000016A	IN
4	363LP0808X	Psychiatric/Mental Health Nurse Practitioner	57000016A	IN
5	103TC0700X	Clinical Psychologist	57000016A	IN
6	103TH0100X	Health Service Psychologist	57000016A	IN

Other Identifiers

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

General Provider Information

NPI Number	:	1821124801
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	MERIDIAN PSYCHOLOGICAL ASSOCIATES,P.C.

Provider Business Mailing Address
First Line	:	4401 CENTRAL AVE
Second Line	:
City	:	INDIANAPOLIS
State	:	IN
Zip	:	46205-1822
Country	:	US
Telephone Number	:	317-923-2333
Fax Number	:	317-923-2367

Provider Business Practice Location Address
First Line	:	4401 CENTRAL AVE
Second Line	:
City	:	INDIANAPOLIS
State	:	IN
Zip	:	46205-1822
Country	:	US
Telephone Number	:	317-923-2333
Fax Number	:	317-923-2367

Authorized Official
Title or Position	:	PRACTICE ADMINISTRATOR
Name	:	MS. NADIA TUCKER
Credential	:
Telephone Number	:	317-923-2333

Provider Enumeration Date	:	02/26/2007
Last Update Date	:	03/03/2016

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Directions to “MERIDIAN PSYCHOLOGICAL ASSOCIATES,P.C. ” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

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