Provider Demographics
NPI:1700062692
Name:HEALTH PSYCHOLOGY AND COUNSELING CENTER OF NORTHWEST INDIANA
Entity type:Organization
Organization Name:HEALTH PSYCHOLOGY AND COUNSELING CENTER OF NORTHWEST INDIANA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:JULIA
Authorized Official - Middle Name:
Authorized Official - Last Name:KOCAL
Authorized Official - Suffix:
Authorized Official - Credentials:PSYD
Authorized Official - Phone:219-531-2877
Mailing Address - Street 1:225 WEXFORD RD
Mailing Address - Street 2:
Mailing Address - City:VALPARAISO
Mailing Address - State:IN
Mailing Address - Zip Code:46385-8040
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:8683 CONNECTICUT ST STE B
Practice Address - Street 2:
Practice Address - City:MERRILLVILLE
Practice Address - State:IN
Practice Address - Zip Code:46410-6384
Practice Address - Country:US
Practice Address - Phone:216-531-2877
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-01-10
Last Update Date:2008-01-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Multi-Specialty