Mary Locke, Ph.D. Llc

LBN: Mary Locke, Ph.D. Llc
Mary Locke, Ph.D. Llc is an health care organization with primary practice located at 7337 W Jefferson Blvd Suite 175, Fort Wayne IN 46804-6284. The organization recently has only one registered license in Behavioral Health & Social Service Providers / Clinical, which is considered as the primary health care specialty. Mary Locke, Ph.D. Llc can be contacted via phone (260) 436-7131, or through Locke, Mary via phone (260) 436-7131.

Contact Information

Primary practice address
7337 W Jefferson Blvd Suite 175 Fort Wayne IN 46804-6284
Phone: (260) 436-7131
Fax: (260) 436-5123
Website:
Map and Directions
Authorized official contact:
Name: Locke, Mary PH.D.
Phone: (260) 436-7131

Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Clinical 103TC0700X 20040180 Indiana

Profile Details

NPI number 1548514656
LBN Legal business name Mary Locke, Ph.D. Llc
DBA Doing business as
Authorized official Locke, Mary PH.D.
Entity Organization
Organization subpart 1 No
Enumeration date Oct 29th, 2012
Last updated Oct 29th, 2012 - about 14 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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Identifiers

StateTypeNumberIssuer
All States NPI 1548514656 NPPES
Indiana Other 220850 MEDICARE

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