Provider Demographics
NPI:1144640582
Name:ANXIETY & OCD BEHAVIORAL HEALTH CENTER
Entity type:Organization
Organization Name:ANXIETY & OCD BEHAVIORAL HEALTH CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CLINICAL PSYCHOLOGIST/DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:HEATHER
Authorized Official - Middle Name:
Authorized Official - Last Name:CHIK
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:219-228-7630
Mailing Address - Street 1:900 RIDGE RD
Mailing Address - Street 2:F
Mailing Address - City:MUNSTER
Mailing Address - State:IN
Mailing Address - Zip Code:46321-1726
Mailing Address - Country:US
Mailing Address - Phone:219-228-7630
Mailing Address - Fax:219-228-1083
Practice Address - Street 1:900 RIDGE RD
Practice Address - Street 2:F
Practice Address - City:MUNSTER
Practice Address - State:IN
Practice Address - Zip Code:46321-1726
Practice Address - Country:US
Practice Address - Phone:219-228-7630
Practice Address - Fax:219-228-1083
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-04-24
Last Update Date:2014-04-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN20042623A103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Single Specialty