MEDICARE: GERIATRIC PSYCHIATRIC SERVICES PLLC

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	363L00000X	Nurse Practitioner

General Provider Information

NPI Number	:	1891935144
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	GERIATRIC PSYCHIATRIC SERVICES PLLC

Provider Business Mailing Address
First Line	:	28800 RYAN RD
Second Line	:	SUITE 320
City	:	WARREN
State	:	MI
Zip	:	48092-4272
Country	:	US
Telephone Number	:	586-620-8100
Fax Number	:	866-227-7418

Provider Business Practice Location Address
First Line	:	9465 COUNSELORS ROW
Second Line	:	SUITE 200
City	:	INDIANAPOLIS
State	:	IN
Zip	:	46240-6423
Country	:	US
Telephone Number	:	586-620-8100
Fax Number	:	866-227-7418

Authorized Official
Title or Position	:	ADMIN DIRECTOR
Name	:	MR. ROBERT A CLEMENTE
Credential	:	ESQ.
Telephone Number	:	586-620-8100

Provider Enumeration Date	:	02/26/2009
Last Update Date	:	01/15/2015

Similar Medicare Providers

1851243836 — KYLIE M CROCKETT ARNP
Practice Location Address:

9465 COUNSELORS ROW
INDIANAPOLIS, IN
46240-6423

Practice Phone: 202-681-9661
Practice Fax:

1073753323 — GERIATRIC PSYCHIATRIC SERVICES PLLC
Practice Location Address:

9465 COUNSELORS ROW , SUITE 200
INDIANAPOLIS, IN
46240-6423

Practice Phone: 586-620-8100
Practice Fax: 866-227-7418

1881834125 — GERIATRIC PSYCHIATRIC SERVICES PLLC
Practice Location Address:

9465 COUNSELORS ROW , SUITE 200
INDIANAPOLIS, IN
46240-6423

Practice Phone: 586-620-8100
Practice Fax: 866-227-7418

1396039996 — INDIANA CENTER FOR FOOT AND ANKLE CARE, PC
Practice Location Address:

9465 COUNSELORS ROW , SUITE 200
INDIANAPOLIS, IN
46240-6423

Practice Phone: 800-578-4043
Practice Fax: 888-524-7464

1689070310 — LORI HABERMEHL
Practice Location Address:

9465 COUNSELORS ROW , SUITE 200
INDIANAPOLIS, IN
46240-6423

Practice Phone: 317-417-6081
Practice Fax: 317-215-0231

1972191062 — MR. JUSTIN MISCH LCSW
Practice Location Address:

9465 COUNSELORS ROW
INDIANAPOLIS, IN
46240-6423

Practice Phone: 574-870-5068
Practice Fax:

Directions to “GERIATRIC PSYCHIATRIC SERVICES PLLC ” 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.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.