INDIANA STATE UNIVERSITY (NPI# 1710097696) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1710097696 |
| Entity Type | Organization |
| Organization Name | INDIANA STATE UNIVERSITY |
| Other Organization Name | ISU PSYCHOLOGY CLINIC-FACULTY PRACTICE SVCS |
| Practice Address |
450 N 7th St Root Hall Terre Haute IN 47809-1928 |
| Practice Telephone | 8122373317 |
| Practice Fax Number | 8122378595 |
| Mailing Telephone | 8122373317 |
| Mailing Fax Number | 8122378595 |
| Enumeration Date | 2006-08-30 |
| Last Update Date | 2020-08-22 |
| Authorized Official Name | MRS. JUNE SPROCK (CLINIC DIRECTOR) |
| Authorized Official Telephone | 8122373317 |
| Authorized Official Credential | PH.D., HSPP |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 103TC0700X |
Psychologist Specialization: Clinical |
IN | Behavioral Health & Social Service Providers |
| Other Name | Type Code |
|---|---|
| ISU Psychology Clinic-Faculty Practice Svcs | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1063612257 | Indiana State University | Clinic/Center | 567 N 5th St., Terre Haute, IN 47809 | 2007-07-25 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| System for Award Management (SAM) Entities | INDIANA STATE UNIVERSITY | 200 N 7th St, Terre Haute, IN 47809-1902 |
| System for Award Management (SAM) Entities | INDIANA STATE UNIVERSITY FEDERAL CREDIT UNION | 444 N 3rd St, Terre Haute, IN 47807-2925 |
| Oklahoma Business Registrations | INDIANA STATE UNIVERSITY FOUNDATION, INC. | 30 N 5th St, Terre Haute, IN 47809 |
| Indiana Business Entities | INDIANA STATE UNIVERSITY FOUNDATION, INC. | 30 N. 5th St., Terre Haute, IN 47809 |
| Street Address |
450 N 7TH ST ROOT HALL |
| City | TERRE HAUTE |
| State | IN |
| Zip Code | 47809-1928 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1952600413 | Kevin Jordan | Psychologist | 450 N 7th St, Root Hall, Terre Haute, IN 47809-1928 | 2011-03-23 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1699291658 | Shunnosuke Hayashi | Specialist/Technologist | 567 N 5th Street, Scwam 257, Terre Haute, IN 47809 | 2017-08-21 |
| 1730502386 | Joseph Rosauer | Specialist/Technologist | 567 N 5th Street, Sycamore Center for Health and Wellness, Terre Haute, IN 47809 | 2014-01-31 |
| 1063612257 | Indiana State University | Clinic/Center | 567 N 5th St., Terre Haute, IN 47809 | 2007-07-25 |
| 1104851831 | Megan Eileen Tucker | Genetic Counselor, MS | 600 Chestnut St., Science 277, Indiana State University, Terre Haute, IN 47809 | 2006-07-11 |
| 1114410750 | Justin Michael Applegate | Physical Therapist | 567 N 5th St, Terre Haute, IN 47809 | 2018-06-08 |
| 1639626732 | Zoe Lindsley | Specialist/Technologist | 168 Lincoln Quads, Terre Haute, IN 47809-0001 | 2016-09-06 |
| 1174889349 | Shanice Johnson | Specialist/Technologist | Wellness and Applied Medicine Rm 201 5th St, Terre Haute, IN 47809-0001 | 2012-04-02 |
| 1164702452 | Janis Leigh | Psychologist | Indiana State University Psycholog Clinic, Root Hall, Terre Haute, IN 47809-0001 | 2011-08-18 |
| 1447566013 | David John Dziedzicki | Specialist/Technologist | Student Services Building Rm 201, Terre Haute, IN 47809-0001 | 2010-08-20 |
| 1487813028 | Mary Catherine Tucker | Counselor | 1511 College of Education, Indiana State University, Terre Haute, IN 47809-0001 | 2008-06-09 |
| Find all providers in zip 47809 | ||||
| Taxonomy Code | 103TC0700X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Psychologist |
| Specialization | Clinical |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1447722483 | Steven James Eckert | Psychologist | 4700 Bureau Rd N, Terre Haute, IN 47802-8246 | 2018-12-31 |
| 1710390034 | Lloyd Kenneth Chew Jr. | Psychologist | 1274 Watertree Rd, Terre Haute, IN 47803-7715 | 2014-06-04 |
| 1205985173 | Kathleen M. Hilton | Psychologist | 7-b The Meadows, Terre Haute, IN 47803-2373 | 2007-01-09 |
| 1629143284 | Jean L. Kristeller | Psychologist | Psychology Department, Indiana State University, Terre Haute, IN 47809-0001 | 2006-11-21 |
| 1720030018 | Leslie Bissell | Psychologist | 88 Wabash Ct, Terre Haute, IN 47807-3439 | 2006-05-16 |
| 1639158348 | Kenneth J. Victor, Psyd, Hspp, LLC | Psychologist | 2321 N 10th St, Terre Haute, IN 47804-2310 | 2006-01-11 |
| 1588657514 | Michael J Urban | Psychologist | 2740 S 7th St, Terre Haute, IN 47802-3559 | 2005-08-24 |
| 1316930357 | Suellyn M Mahan | Psychologist | 1400 E Pugh Dr, Suite 3, Terre Haute, IN 47802-3942 | 2005-08-24 |
| 1740289834 | Bridget J Roberts-pittman | Psychologist | 500 8th Ave, Terre Haute, IN 47804-4072 | 2005-07-20 |
| 1225695745 | Wabash Valley Therapy, LLC | Psychologist | 609 E Surgery Center Dr, Terre Haute, IN 47802-6815 | 2019-05-20 |
| Find all providers in TERRE HAUTE | ||||
| City | TERRE HAUTE |
| Zip Code | 47809 |
Please comment or provide details below to improve the information on INDIANA STATE UNIVERSITY.
| 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.