Provider Demographics
NPI:1457332710
Name:CLINICAL PSYCHOLOGICAL ASSESSMENT & CONSULTING, PC
Entity Type:Organization
Organization Name:CLINICAL PSYCHOLOGICAL ASSESSMENT & CONSULTING, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRES, OWNER, CLINICAL PSYCHOLOGIST
Authorized Official - Prefix:DR
Authorized Official - First Name:STEPHANIE
Authorized Official - Middle Name:L
Authorized Official - Last Name:SCIFRES
Authorized Official - Suffix:
Authorized Official - Credentials:PHD, HSPP
Authorized Official - Phone:812-793-2570
Mailing Address - Street 1:139 S EAST ST
Mailing Address - Street 2:PO BOX 7
Mailing Address - City:CROTHERSVILLE
Mailing Address - State:IN
Mailing Address - Zip Code:47229-9635
Mailing Address - Country:US
Mailing Address - Phone:812-793-2570
Mailing Address - Fax:812-793-2570
Practice Address - Street 1:139 S EAST ST
Practice Address - Street 2:
Practice Address - City:CROTHERSVILLE
Practice Address - State:IN
Practice Address - Zip Code:47229-9635
Practice Address - Country:US
Practice Address - Phone:812-793-2570
Practice Address - Fax:812-793-2570
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-11-14
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN57000116A103TC0700X, 103TH0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Not Answered103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Multi-Specialty
Not Answered103TH0100XBehavioral Health & Social Service ProvidersPsychologistHealth ServiceGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN000000381792OtherANTHEM BCBS
IN064755OtherSIHO
IL258751OtherCOMPSYCH
UT0393476OtherUNITED HEALTHCARE
OH82272400OtherMAGELLAN
OH000000381784OtherANTHEM BCBS
CT7627650OtherAETNA
TXC 231810OtherUNITED AMERICAN INSURANCE
GADE0072OtherMEDICARE RAILROAD CARRIER
UT0393476OtherUNITED HEALTHCARE
CT7627650OtherAETNA
OH000000381784OtherANTHEM BCBS
IN064755OtherSIHO
WI=========OtherAMERICAN FAMILY INSURANCE
GADE0072OtherMEDICARE RAILROAD CARRIER
OH=========100OtherCARESOURCE