Provider Demographics
NPI:1770873853
Name:DYARMAN, JENNIFER (PSYD LCSW LCAC)
Entity type:Individual
Prefix:DR
First Name:JENNIFER
Middle Name:
Last Name:DYARMAN
Suffix:
Gender:F
Credentials:PSYD LCSW LCAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:417 W 81ST AVE # 132
Mailing Address - Street 2:
Mailing Address - City:MERRILLVILLE
Mailing Address - State:IN
Mailing Address - Zip Code:46410-5317
Mailing Address - Country:US
Mailing Address - Phone:219-804-6262
Mailing Address - Fax:877-473-3169
Practice Address - Street 1:417 W 81ST AVE # 132
Practice Address - Street 2:
Practice Address - City:MERRILLVILLE
Practice Address - State:IN
Practice Address - Zip Code:46410-5317
Practice Address - Country:US
Practice Address - Phone:219-804-6262
Practice Address - Fax:877-473-3169
Is Sole Proprietor?:No
Enumeration Date:2011-04-11
Last Update Date:2024-12-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
103T00000X
IN87001541A101YA0400X
IN34006895A1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No103T00000XBehavioral Health & Social Service ProvidersPsychologist
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)