Provider Demographics
NPI:1598785404
Name:HEBBAR, USHA (PHD, CCC-A)
Entity Type:Individual
Prefix:
First Name:USHA
Middle Name:
Last Name:HEBBAR
Suffix:
Gender:F
Credentials:PHD, CCC-A
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:208 S CHESTNUT ST
Mailing Address - Street 2:
Mailing Address - City:SEYMOUR
Mailing Address - State:IN
Mailing Address - Zip Code:47274-2328
Mailing Address - Country:US
Mailing Address - Phone:812-523-6666
Mailing Address - Fax:
Practice Address - Street 1:208 S CHESTNUT ST
Practice Address - Street 2:
Practice Address - City:SEYMOUR
Practice Address - State:IN
Practice Address - Zip Code:47274-2328
Practice Address - Country:US
Practice Address - Phone:812-523-6666
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-07-20
Last Update Date:2010-06-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN23002089231H00000X, 231HA2400X, 237600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist
No231HA2400XSpeech, Language and Hearing Service ProvidersAudiologistAssistive Technology Practitioner
No237600000XSpeech, Language and Hearing Service ProvidersAudiologist-Hearing Aid Fitter
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN381400POtherSIHO
IN200335660AMedicaid
IN000000187289OtherBCBS / ANTHEM AUD TEST
IN000000187290OtherBCBS ANTHEM - HEARING AID
IN200335660AMedicaid
IN000000187290OtherBCBS ANTHEM - HEARING AID