Provider Demographics
NPI:1225198203
Name:WOODVIEW PSYCHOLOGY GROUP
Entity Type:Organization
Organization Name:WOODVIEW PSYCHOLOGY GROUP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CO-OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:PAM
Authorized Official - Middle Name:
Authorized Official - Last Name:CHRISTY
Authorized Official - Suffix:
Authorized Official - Credentials:PSYD, HSPP
Authorized Official - Phone:317-573-0149
Mailing Address - Street 1:70 E 91ST ST
Mailing Address - Street 2:SUITE 210
Mailing Address - City:INDIANAPOLIS
Mailing Address - State:IN
Mailing Address - Zip Code:46240-1561
Mailing Address - Country:US
Mailing Address - Phone:317-573-0149
Mailing Address - Fax:317-573-0154
Practice Address - Street 1:70 E 91ST ST
Practice Address - Street 2:SUITE 210
Practice Address - City:INDIANAPOLIS
Practice Address - State:IN
Practice Address - Zip Code:46240-1561
Practice Address - Country:US
Practice Address - Phone:317-573-0149
Practice Address - Fax:317-573-0154
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-11
Last Update Date:2016-03-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN20041691A103TC0700X
IN20041891A103TC0700X
IN20042133A103TC0700X
IN20041351103TC0700X
IN20042436A103TC0700X
IN20041804A103TC0700X
IN20042876A103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Single Specialty