KELLY S EARNST (NPI# 1104900489) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1104900489 |
| Entity Type | Individual |
| Full Name | KELLY S EARNST |
| Credential | PH.D, HSPP |
| Practice Address |
1415 Salem St Suite 102 Lafayette IN 47904-4100 |
| Mailing Address |
1607 Ravinia Rd West Lafayette IN 47906-2361 |
| Practice Telephone | 7657421816 |
| Practice Fax Number | 7657422557 |
| Mailing Telephone | 7657421826 |
| Enumeration Date | 2006-10-24 |
| Last Update Date | 2010-08-05 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 103G00000X | Clinical Neuropsychologist | 20041614A | Behavioral Health & Social Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| IN | 200283610A | 05 |
| Street Address |
1415 SALEM ST SUITE 102 |
| City | LAFAYETTE |
| State | IN |
| Zip Code | 47904-4100 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1619970134 | Franciscan Health Lafayette | Home Health | 1415 Salem St, Suite 202w, Lafayette, IN 47904-2099 | 2005-05-30 |
| 1134335383 | Diane Farkas | Pharmacist | 1415 Salem St, Suite B9, Lafayette, IN 47904-4100 | 2007-05-15 |
| 1275616351 | Franciscan Health Lafayette | Pharmacy | 1415 Salem St, B11, Lafayette, IN 47904-4100 | 2006-10-23 |
| 1104908706 | Jill E Salem | Clinical Neuropsychologist | 1415 Salem St, Suite 102, Lafayette, IN 47904-4100 | 2006-10-20 |
| 1144301110 | Franciscan St. Elizabeth Health | Home Health | 1415 Salem St, Suite 202w, Lafayette, IN 47904-4100 | 2006-10-18 |
| 1053492025 | Franciscan St. Elizabeth Health | Hospice Care, Community Based | 1415 Salem St, Suite 202w, Lafayette, IN 47904-4100 | 2006-10-18 |
| 1861589327 | Gayle Y Iwamasa | Psychologist | 1415 Salem St, Suite 102, Lafayette, IN 47904-4100 | 2006-10-06 |
| 1336142785 | Franciscan Health Lafayette | Hospice Care, Community Based | 1415 Salem St, Suite 202w, Lafayette, IN 47904-2099 | 2005-05-31 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1568998615 | Angela Hands | Physical Therapy Assistant | 1260 North 17th Street, Lafayette, IN 47904 | 2017-05-11 |
| 1366894164 | Kathryn Barnett | Behavioral Analyst | 2785 Cason St # 2, Lafayette, IN 47904 | 2016-07-06 |
| 1881972917 | Rest Assured, LLC | Durable Medical Equipment & Medical Supplies | 180 Professional Ct., Lafayette, IN 47904 | 2011-07-22 |
| 1144514233 | Michelle Cristin Singleton | Dietitian, Registered | 508 N 26th St, Lafayette, IN 47904 | 2011-06-06 |
| 1912134438 | Jean D Trammel | Marriage & Family Therapist | 2000 Greenburg St, Bldg B, Suite A, Lafayette, IN 47904 | 2009-06-11 |
| 1902946056 | Terry Richard Baker | Optometrist | 2300 Sagamore Parkway S, Lafayette, IN 47904 | 2007-02-07 |
| 1891862165 | Becki A Bowditch Inc | Social Worker | 2201 Ferry Street, Lafayette, IN 47904 | 2006-11-29 |
| 1326121849 | James Lowell Thomas | Pediatrics | 2300 Ferry St, Lafayette, IN 47904 | 2006-10-21 |
| 1700976719 | Michael Leonard Bagnoli | Dentist | 2020 Union Street, Suite 200, Lafayette, IN 47904 | 2006-10-13 |
| 1255428801 | Lynn Arlen Pestle | Dentist | 2550 Elmwood Avenue, Lafayette, IN 47904 | 2006-10-06 |
| Find all providers in zip 47904 | ||||
| Taxonomy Code | 103G00000X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Clinical Neuropsychologist |
| An individual with a doctorate degree, licensure in clinical psychology and specialized training or board certification in neuropsychology who practices or adheres to the principles of neuropsychology; a specialty within the field of psychology focusing primarily on neurobehavioral functioning. |
| Notes: Source: American Psychological Association, Washington, DC, 1997. [1/1/2007: title modified] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1447896253 | Kristen Wortman Psychology, P.C. | Clinical Neuropsychologist | 3738 Mt Diablo Blvd Ste 306, Lafayette, CA 94549-3600 | 2019-11-27 |
| 1295974210 | Gina Lynn Gibson | Clinical Neuropsychologist | 1602 W Pinhook Rd Ste 303, Lafayette, LA 70508-3735 | 2009-02-14 |
| 1396882445 | Elea Bernou | Clinical Neuropsychologist | 3744 Mt Diablo Blvd Ste 305, Lafayette, CA 94549-3602 | 2007-01-30 |
| 1316978935 | Larry James Benoit | Clinical Neuropsychologist | 119 Caillouett Pl, Lafayette, LA 70501-7807 | 2006-07-05 |
| 1831173384 | Janet A Lemmon | Clinical Neuropsychologist | 1120 W South Boulder Rd Ste 201d, Lafayette, CO 80026-8952 | 2005-11-29 |
| 1477023257 | Comprehensive Behavioral Health Center | Clinical Neuropsychologist | 1602 W Pinhook Rd Ste 303, Lafayette, LA 70508-3735 | 2018-12-05 |
| 1164621785 | Bianchini-strother, LLC | Clinical Neuropsychologist | 850 Kaliste Saloom Rd, Suite #103, Lafayette, LA 70508-4230 | 2007-07-13 |
| 1538383831 | Clare Ames-klein | Clinical Neuropsychologist | 895 Moraga Rd, Suite 10, Lafayette, CA 94549-5094 | 2007-04-11 |
| 1578786745 | Glenn A. Ally, Ph.d. | Clinical Neuropsychologist | 155 Hospital Dr, Suite 200, Lafayette, LA 70503-2852 | 2007-04-10 |
| 1437272945 | Glenn A Ally | Clinical Neuropsychologist | 155 Hospital Dr, Suite 200, Lafayette, LA 70503-2852 | 2007-04-09 |
| Find all providers in LAFAYETTE | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.