DR. TERENCE NEAL ANDERSON (NPI# 1275614869) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1275614869 |
| Entity Type | Individual |
| Full Name | DR. TERENCE NEAL ANDERSON |
| Credential | PH.D. |
| Practice Address |
318 Pine Lake Ave La Porte IN 46350-3061 |
| Mailing Address |
318 Pine Lake Ave Box 668 Laporte IN 46352-0668 |
| Practice Telephone | 2193246263 |
| Practice Fax Number | 2193246263 |
| Mailing Telephone | 2193246263 |
| Mailing Fax Number | 2193246263 |
| Enumeration Date | 2006-10-18 |
| Last Update Date | 2008-01-07 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 103T00000X | Psychologist | 20010366 HSPP | IN | Behavioral Health & Social Service Providers |
| N | 103TC0700X |
Psychologist Specialization: Clinical |
20010366 HSPP | IN | Behavioral Health & Social Service Providers |
| Y | 103TH0100X |
Psychologist Specialization: Health Service |
20010366 HSPP | IN | Behavioral Health & Social Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| IN | BLUE CROSS | 000000183576 | 01 |
| IN | VALUE OPTION | 010676 | 01 |
| Street Address |
318 PINE LAKE AVE |
| City | LA PORTE |
| State | IN |
| Zip Code | 46350-3061 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1922113919 | Susan Diane Anderson | Social Worker | 318 Pine Lake Ave, La Porte, IN 46350-3061 | 2006-08-20 |
| 1396842415 | Elena C Mrozinske | Social Worker | 318 Pine Lake Ave, La Porte, IN 46350-3061 | 2006-09-20 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1871139246 | Carolyn Ann Perra | Pharmacist | 55 Pine Lake S.c., Laporte, IN 46350 | 2019-11-20 |
| 1306496492 | Trinity Healthcare Inc. | Occupational Therapist | 2002 Andrew Avenue, Laporte, IN 46350 | 2019-09-19 |
| 1184136665 | Diane Margaret Rich | Physical Therapist | 1643 S Willow Bend Dr, La Porte, IN 46350 | 2017-10-24 |
| 1114460102 | Judith Marie Fitzhugh | Dietitian, Registered | 1775 S. Basswood Trail, Laporte, IN 46350 | 2016-11-23 |
| 1568916971 | Total Renal Care, Inc. | Clinic/Center | 1406 E Lincolnway, Ste A, La Porte, IN 46350 | 2016-08-15 |
| 1083079008 | Irene Torres | Nurse Practitioner | 1407 Lincolnway, La Porte, IN 46350 | 2015-12-17 |
| 1124422910 | Becky Alwood-wallace | Occupational Therapist | 1203 Washington Street, Iu Health La Porte Hospital Wellness & Rehabilitation, La Porte, IN 46350 | 2014-10-22 |
| 1881001527 | Johnson Memorial Hospital | Skilled Nursing Facility | 3530 Monroe Street, La Porte, IN 46350 | 2014-07-15 |
| 1306268941 | Tiffany Anne Satterfield | Physical Therapy Assistant | 194 S 400 E, Laporte, IN 46350 | 2014-01-16 |
| 1801122239 | Mary Barbara Backer | Internal Medicine | 301 Willow Bend Dr, La Porte, IN 46350 | 2009-10-20 |
| Find all providers in zip 46350 | ||||
| Taxonomy Code | 103TH0100X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Psychologist |
| Specialization | Health Service |
| A psychologist, certified/licensed at the independent practice level in his/her state, who is duly trained and experienced in the delivery of direct, preventative, assessment, and therapeutic intervention services to individuals whose growth, adjustment, or functioning is actually impaired or is demonstrably at high risk of impairment (1974). |
| Notes: Source: National Register of Health Service Providers in Psychology website http://www.nationalregister.org/about_NR.html [7/1/2006: modified title, added definition] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1962993063 | Nicole C Allen | Psychologist | 595 W Edge Trl Apt O, Avon, IN 46123-6841 | 2018-05-24 |
| 1720436488 | Youth Opportunity Center | Psychologist | 103 W County Road 100 N, New Castle, IN 47362-8965 | 2016-06-02 |
| 1528449964 | Leroy Burgess | Psychologist | 300 S Saint Louis Blvd Ste 202, South Bend, IN 46617-3044 | 2015-06-11 |
| 1144555855 | Paula A. Neuman | Psychologist | 750 Broadway Ste 350, Fort Wayne, IN 46802-1412 | 2009-10-14 |
| 1942491600 | Dixie J Pederson | Psychologist | 2 N 19th St, Lafayette, IN 47904-2950 | 2007-08-07 |
| 1285839480 | Center for Brief Therapy PC | Psychologist | 423 Airport N. Office Park, Ft. Wayne, IN 46825-6704 | 2007-06-18 |
| 1376600767 | Bart Ferraro | Psychologist | 2011 N Meridian St, Indianapolis, IN 46202-1305 | 2007-01-03 |
| 1326125998 | Mary Wollitz Dooley | Psychologist | 7125 E Us Hwy 36, Avon, IN 46123 | 2006-11-01 |
| 1235247396 | Linda Ohlsen Ferreira | Psychologist | 23 East 39th Street, Indianapolis, IN 46205-2645 | 2006-08-29 |
| 1497798284 | Victory Clinical Services II LLC | Psychologist | 4218 W Western Ave, South Bend, IN 46619-2622 | 2006-06-13 |
| Find all providers with the same taxonomy | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.