SERDAN GROUP, LLC (NPI# 1487821856) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1487821856 |
Entity Type | Organization |
Organization Name | SERDAN GROUP, LLC |
Other Organization Name | KIMBERLY G. MONTGOMERY, PH.D. HSPP |
Practice Address |
10585 N Meridian St Suite 340 Indianapolis IN 46290-1069 |
Practice Telephone | 3175804007 |
Practice Fax Number | 3175804010 |
Mailing Telephone | 3175804007 |
Mailing Fax Number | 3175804010 |
Enumeration Date | 2008-05-14 |
Last Update Date | 2008-05-14 |
Authorized Official Name | DR. KIMBERLY G. MONTGOMERY (PSYCHOLOGIST) |
Authorized Official Telephone | 3175804007 |
Authorized Official Credential | PH.D., HSPP |
Is Organization Subpart | N |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 261QM0801X |
Clinic/Center Specialization: Mental Health (Including Community Mental Health Center) |
20040771 | IN | Ambulatory Health Care Facilities |
Other Name | Type Code |
---|---|
Kimberly G. Montgomery, PH.D. HSPP | Doing Business As Name - Organization |
Street Address |
10585 N MERIDIAN ST SUITE 340 |
City | INDIANAPOLIS |
State | IN |
Zip Code | 46290-1069 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1497808703 | Teresa D. Erickson | Physical Therapist | 10585 N Meridian St, Suite 201, Indianapolis, IN 46290-1069 | 2007-01-19 |
1033552310 | Axon Health Associates, LLC | Psychiatry & Neurology | 10585 N Meridian St, Suite 201, Indianapolis, IN 46290-1069 | 2013-04-16 |
1346453941 | Ana Velia Cofresi | Psychologist | 10585 N Meridian St, Suite 340, Indianapolis, IN 46290-1069 | 2007-05-08 |
1609996388 | Choices Psychology Consultation Center, Inc. | Psychologist | 10585 N Meridian St, Suite 340, Indianapolis, IN 46290-1069 | 2007-03-29 |
1043352149 | Finlay Grier | Psychologist | 10585 N Meridian St, Suite 340, Indianapolis, IN 46290-1069 | 2007-02-13 |
1740320977 | Philip Meredith Coons | Psychiatry & Neurology | 10585 N Meridian St, Suite 340, Indianapolis, IN 46290-1069 | 2007-02-07 |
1235276692 | Sarah Hermann Russell | Psychologist | 10585 N Meridian St, Suite 340, Indianapolis, IN 46290-1069 | 2007-02-01 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1821548777 | American Behavioral Counseling | Social Worker | 10386 Spring Highland Dr, Indianapolis, IN 46290 | 2016-10-04 |
1518042431 | James Lamar Jones | Psychologist | 8555 Cedar Place, Suite 113a, Indianapolis, IN 46290 | 2006-10-26 |
1437245917 | Bradley Scott Gunter | Physical Therapy Assistant | 10601 N. Meridian St., Suite 110, Indianapolis, IN 46290 | 2006-10-04 |
1790261576 | Kristiana Michelle Sannella | Physician Assistant | 10590 N Meridian St # 105, Indianapolis, IN 46290 | 2018-07-16 |
1023534815 | Mitchell James Vansumeren | Psychologist | 10291 N Meridian St Ste 310, Indianapolis, IN 46290 | 2017-08-14 |
1801281670 | Elizabeth Tibbs | Physician Assistant | 10590 N Meridian St Ste 105, Indianapolis, IN 46290 | 2015-03-30 |
1447510722 | Bradley A Clark | Internal Medicine | 10590 N Meridian St, Indianapolis, IN 46290 | 2012-05-21 |
1528333861 | Edward Mark Shmukler | Internal Medicine | 10590 N Meridian St, Indianapolis, IN 46290 | 2012-03-20 |
1386938272 | Bryce S Lynn | Internal Medicine | 10590 N Meridian St, Indianapolis, IN 46290 | 2011-06-08 |
1063610301 | Babar Sultan | Otolaryngology | 170 W 106th St, Meridian Plastic Surgery, Indianapolis, IN 46290 | 2007-07-09 |
Find all providers in zip 46290 |
Taxonomy Code | 261QM0801X |
Grouping | Ambulatory Health Care Facilities |
Classification | Clinic/Center |
Specialization | Mental Health (Including Community Mental Health Center) |
Definition to come... |
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1144722695 | Mindful Services Center LLC | Clinic/Center | 9002 N Meridian St, Ste 200, Indianapolis, IN 46260 | 2018-03-01 |
1073042396 | Amanda Rinehart | Clinic/Center | 8305 Christiana Ln, Indianapolis, IN 46256-3415 | 2017-06-08 |
1063782803 | Teague Psychological Services, Inc. | Clinic/Center | 6470 N. Shadeland, Suite C, Indianapolis, IN 46220 | 2012-01-11 |
Find all providers in INDIANAPOLIS |
City | INDIANAPOLIS |
Zip Code | 46290 |
Please comment or provide details below to improve the information on SERDAN GROUP, LLC.
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.