Provider Demographics
NPI:1780892349
Name:ZIONSVILLE PSYCHOLOGICAL SERVICES PC
Entity type:Organization
Organization Name:ZIONSVILLE PSYCHOLOGICAL SERVICES PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:DOUGLAS
Authorized Official - Middle Name:KENNETH
Authorized Official - Last Name:USELDING
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:317-873-6265
Mailing Address - Street 1:3420 WINDY KNOLL LN
Mailing Address - Street 2:
Mailing Address - City:WESTFIELD
Mailing Address - State:IN
Mailing Address - Zip Code:46074-8378
Mailing Address - Country:US
Mailing Address - Phone:317-873-6265
Mailing Address - Fax:
Practice Address - Street 1:3420 WINDY KNOLL LN
Practice Address - Street 2:
Practice Address - City:WESTFIELD
Practice Address - State:IN
Practice Address - Zip Code:46074-8378
Practice Address - Country:US
Practice Address - Phone:317-873-6265
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-18
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN57000045103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Single Specialty