Provider Demographics
NPI:1538218250
Name:ANAND, SHASHI (PHD)
Entity type:Individual
Prefix:DR
First Name:SHASHI
Middle Name:
Last Name:ANAND
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2200 RIDGE
Mailing Address - Street 2:
Mailing Address - City:HIGHLAND
Mailing Address - State:IN
Mailing Address - Zip Code:46322
Mailing Address - Country:US
Mailing Address - Phone:219-838-3950
Mailing Address - Fax:219-838-3950
Practice Address - Street 1:2200 RIDGE RD
Practice Address - Street 2:
Practice Address - City:HIGHLAND
Practice Address - State:IN
Practice Address - Zip Code:46322
Practice Address - Country:US
Practice Address - Phone:219-838-3950
Practice Address - Fax:219-838-3950
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-10
Last Update Date:2008-10-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN20040736103TC0700X
IN35000065A106H00000X
IL166000424106H00000X
IL071.007557103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
No106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN100147630AMedicaid
IN404710Medicare ID - Type Unspecified
IN100147630AMedicaid