SOUGANDHI BACKHAUS (NPI# 1780638619) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1780638619 |
| Entity Type | Individual |
| Full Name | SOUGANDHI BACKHAUS |
| Credential | PHD |
| Practice Address |
4141 Shore Dr Indianapolis IN 46254-2607 |
| Mailing Address |
6804 Wood Haven Pl Zionsville IN 46077-8560 |
| Practice Telephone | 3173292219 |
| Mailing Telephone | 3178798940 |
| Mailing Fax Number | 3178720914 |
| Enumeration Date | 2006-05-22 |
| Last Update Date | 2011-07-01 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 103G00000X | Clinical Neuropsychologist | 20041993 | IN | Behavioral Health & Social Service Providers |
| N | 103TC0700X |
Psychologist Specialization: Clinical |
20041993 | IN | Behavioral Health & Social Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| IN | 200285860 | 05 |
| Street Address |
4141 SHORE DR |
| City | INDIANAPOLIS |
| State | IN |
| Zip Code | 46254-2607 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1619925179 | Aisha Faryal Zafar | Internal Medicine | 4141 Shore Dr, Unit One, Indianapolis, IN 46254-2607 | 2006-05-05 |
| 1033718101 | Himanshu Saini | Physical Therapist | 4141 Shore Dr, Indianapolis, IN 46254-2607 | 2020-10-20 |
| 1871076794 | Hope Lowhorn | Registered Nurse | 4141 Shore Dr, Indianapolis, IN 46254-2607 | 2018-09-07 |
| 1437645587 | Rehabilitation Hospital of Indiana, Inc. | Pharmacy | 4141 Shore Dr, Indianapolis, IN 46254-2607 | 2018-07-02 |
| 1326539586 | Molly Volden | Physical Therapist | 4141 Shore Dr, Indianapolis, IN 46254-2607 | 2018-05-23 |
| 1700383064 | Daniel Schramm | Student in an Organized Health Care Education/Training Program | 4141 Shore Dr, Indianapolis, IN 46254 | 2018-04-12 |
| 1457608648 | Rachel E Milstead | Physician Assistant | 4141 Shore Dr, Indianapolis, IN 46254-2607 | 2012-08-07 |
| 1164782348 | Kyle Aaron Littell | Physical Medicine & Rehabilitation | 4141 Shore Dr, Indianapolis, IN 46254-2607 | 2012-05-22 |
| 1861686826 | Professional Assoc. PC | Internal Medicine | 4141 Shore Dr, Indianapolis, IN 46254-2607 | 2007-09-04 |
| 1356566137 | Rehabilitation Physicians of Indiana LLC | Clinical Neuropsychologist | 4141 Shore Dr, Indianapolis, IN 46254-2607 | 2007-04-16 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1427673052 | Sanders Empowerment Services LLC | Social Worker | 5026 Clarkson Drive, Indianapolis, IN 46254 | 2020-06-09 |
| 1316587660 | Yulisa Carrera-ochoa | Behavior Technician | 6925 Parkdale Place, Indianapolis, IN 46254 | 2020-01-14 |
| 1396230140 | Emeri Taivalkoski | Registered Nurse | Eskenazi Health West 38th Street, 5515 38th St, Indianapolis, IN 46254 | 2018-06-25 |
| 1811499759 | Sara Peterson | Speech-Language Pathologist | 4102 Shore Drive, Indianapolis, IN 46254 | 2018-03-07 |
| 1427560002 | Swan Garden Home Services LLC | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 4906 Quail Ridge Ln, Indianapolis, IN 46254 | 2017-11-03 |
| 1477083475 | Sherry Mason | Counselor | 5959 Staffordshire Cir, Indianapolis, IN 46254 | 2017-06-13 |
| 1790111680 | The Health and Hospital Corporation of Marion County | Pharmacy | 5515 W 38th St Ste 1200, Indianapolis, IN 46254 | 2013-09-24 |
| 1790051563 | Theracare | Skilled Nursing Facility | 5356 Holly Springs Ct, Indianapolis, IN 46254 | 2012-03-27 |
| 1750659827 | Apollon | Counselor | 5362 Deer Creek Drive, Indianapolis, IN 46254 | 2011-12-05 |
| 1235413253 | Irene Williams | Pharmacist | 6269 W. 38th St, Indianapolis, IN 46254 | 2011-10-10 |
| Find all providers in zip 46254 | ||||
| Taxonomy Code | 103G00000X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Clinical Neuropsychologist |
| An individual with a doctorate degree, licensure in clinical psychology and specialized training or board certification in neuropsychology who practices or adheres to the principles of neuropsychology; a specialty within the field of psychology focusing primarily on neurobehavioral functioning. |
| Notes: Source: American Psychological Association, Washington, DC, 1997. [1/1/2007: title modified] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1497273015 | Jana Beth Dykstra | Clinical Neuropsychologist | 355 W 16th Street Goodman Hall, Indianapolis, IN 46202 | 2017-09-04 |
| 1558779355 | Neurobehavioral Consultants, LLC | Clinical Neuropsychologist | 4356 N College Ave, Indianapolis, IN 46205-1932 | 2014-07-24 |
| 1306170626 | Elizabeth Begyn | Clinical Neuropsychologist | 541 Clinical Dr # Cl285, Indianapolis, IN 46202-5233 | 2009-09-21 |
| 1215101696 | Michelle Anne Keiski | Clinical Neuropsychologist | 355 W 16th St Ste 4700, Indianapolis, IN 46202-2285 | 2008-04-17 |
| 1447477088 | Robert Nolan Mckinney | Clinical Neuropsychologist | 2596 N Girls School Rd, Indianapolis, IN 46214-2105 | 2007-04-18 |
| 1003833096 | Raymond W Horn | Clinical Neuropsychologist | 10293 N Meridian St Ste 210, Indianapolis, IN 46290-1079 | 2006-07-16 |
| 1255327748 | Gwen C Sprehn | Clinical Neuropsychologist | Dept of Neurology Indiana University School of Med, 541 Clinical Drive (cl-299), Indianapolis, IN 46202 | 2005-09-21 |
| 1972595684 | Leslie Jay Suga | Clinical Neuropsychologist | 6515 E 82nd St, Suite 210, Indianapolis, IN 46250-1576 | 2005-08-18 |
| 1285639476 | Odie L Bracy IIi | Clinical Neuropsychologist | 6555 Carrollton Ave, Indianapolis, IN 46220-1664 | 2005-06-15 |
| 1811506769 | Midwest Supervision and Evaluation | Clinical Neuropsychologist | 450 E 96th St Ste 500, Indianapolis, IN 46240-3760 | 2020-07-27 |
| Find all providers in INDIANAPOLIS | ||||
| City | INDIANAPOLIS |
| Zip Code | 46254 |
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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.