Provider Demographics
NPI:1477543684
Name:FLAGSTONE PSYCHOLOGY, P.C.
Entity Type:Organization
Organization Name:FLAGSTONE PSYCHOLOGY, P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PSYCHOLOGIST
Authorized Official - Prefix:DR
Authorized Official - First Name:APRIL
Authorized Official - Middle Name:J
Authorized Official - Last Name:FAIDLEY
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:317-888-5606
Mailing Address - Street 1:7662 US HIGHWAY 31 S
Mailing Address - Street 2:
Mailing Address - City:INDIANAPOLIS
Mailing Address - State:IN
Mailing Address - Zip Code:46227-8547
Mailing Address - Country:US
Mailing Address - Phone:317-888-5606
Mailing Address - Fax:317-888-5612
Practice Address - Street 1:7662 US HIGHWAY 31 S
Practice Address - Street 2:
Practice Address - City:INDIANAPOLIS
Practice Address - State:IN
Practice Address - Zip Code:46227-8547
Practice Address - Country:US
Practice Address - Phone:317-888-5606
Practice Address - Fax:317-888-5612
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-10-27
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN20040834261QM0850X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0850XAmbulatory Health Care FacilitiesClinic/CenterAdult Mental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN215340AMedicare ID - Type Unspecified