WILLOWGLEN ACADEMY-IN, INC (NPI# 1972933349) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1972933349 |
| Entity Type | Organization |
| Organization Name | WILLOWGLEN ACADEMY-IN, INC |
| Practice Address |
4955 Broadway Gary IN 46409-2706 |
| Mailing Address |
308 E 21st Ave Gary IN 46407-2618 |
| Practice Telephone | 2198861320 |
| Mailing Telephone | 2198861320 |
| Enumeration Date | 2013-11-20 |
| Last Update Date | 2013-11-20 |
| Authorized Official Name | CATHERINE ANDERSON (CLINICAL MANAGER) |
| Authorized Official Telephone | 2198861320 |
| Authorized Official Credential | LCSW, LCAC |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 1041C0700X |
Social Worker Specialization: Clinical |
344004861A | IN | Behavioral Health & Social Service Providers |
| N | 1041C0700X |
Social Worker Specialization: Clinical |
34002639A | IN | Behavioral Health & Social Service Providers |
| N | 163W00000X | Registered Nurse | 28072804A | IN | Nursing Service Providers |
| Y | 2084P0800X |
Psychiatry & Neurology Specialization: Psychiatry |
0103158A | IN | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| IN | 200185860 | 05 |
| Street Address |
4955 BROADWAY |
| City | GARY |
| State | IN |
| Zip Code | 46409-2706 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1316027998 | Nhi Home Base Service Corp. | Clinic/Center | 4795 Broadway, Gary, IN 46409 | 2006-10-17 |
| 1164891404 | Megan Burgess | Counselor | 4795 Broadway, Gary, IN 46409 | 2015-09-16 |
| 1366677213 | Merideth Krashonda Owens | Counselor | 4795 Broadway, Gary, IN 46409 | 2009-05-21 |
| 1548530439 | Sibis Counseling Center LLC | Counselor | 3195 Broadway Lowr Level, Gary, IN 46409-1006 | 2012-01-09 |
| 1750303343 | Adolphus A Anekwe | Specialist | 3195 Broadway, Gary, IN 46409-1006 | 2006-07-24 |
| 1215219084 | Broadway Dental Services | Dentist | 3195 Broadway, Gary, IN 46409-1006 | 2011-09-16 |
| 1528392156 | Tonya A. Harvey | Nurse Practitioner | 3195 Broadway, Gary, IN 46409-1006 | 2009-09-29 |
| 1629196761 | Broadway Medical Corporation, PC | Specialist | 3195 Broadway, Gary, IN 46409-1006 | 2007-03-27 |
| 1023166758 | Frank Edward Pate | Dentist | 3195 Broadway, Gary, IN 46409-1006 | 2007-01-08 |
| 1528173853 | Edwin Kenneth Mcdonald IIi | Dentist | 3195 Broadway, Gary, IN 46409-1006 | 2006-08-19 |
| Find all providers in zip 46409 | ||||
| Taxonomy Code | 2084P0800X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Psychiatry & Neurology |
| Specialization | Psychiatry |
| A Psychiatrist specializes in the prevention, diagnosis, and treatment of mental disorders, emotional disorders, psychotic disorders, mood disorders, anxiety disorders, substance-related disorders, sexual and gender identity disorders and adjustment disorders. Biologic, psychological, and social components of illnesses are explored and understood in treatment of the whole person. Tools used may include diagnostic laboratory tests, prescribed medications, evaluation and treatment of psychological and interpersonal problems with individuals and families, and intervention for coping with stress, crises, and other problems. |
| Notes: Source: The American Board of Psychiatry and Neurology, Inc. www.abpn.com [1/1/2007: new definition] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1992920169 | Paul L. Hannah | Psychiatry & Neurology | 3787 Grant St, Gary, IN 46408-2142 | 2007-04-14 |
| 1790805448 | Beatrice Alexandria Nelson Brewer | Psychiatry & Neurology | 4844 Broadway, Gary, IN 46408-4509 | 2007-03-29 |
| 1376677138 | Kovilparambil Xavier Antony | Psychiatry & Neurology | 1100 W 6th Avenue, Gary, IN 46402 | 2007-03-15 |
| 1912970229 | Mathew V Castelino | Psychiatry & Neurology | 1100 W 6th Ave, Gary, IN 46402-1711 | 2006-02-08 |
| 1629593272 | Paul L. Hannah, M.d., M.s. Ltd | Psychiatry & Neurology | 3787 Grant St, Gary, IN 46408-2142 | 2017-08-04 |
| 1528284452 | Martha F. Hernandez | Psychiatry & Neurology | 3787 Grant St, Gary, IN 46408-2142 | 2007-04-18 |
| 1881722833 | Muhammad Butt | Psychiatry & Neurology | 1100 W 6th Ave, Gary, IN 46402-1711 | 2007-03-01 |
| 1447386131 | Pamela V. Tran | Psychiatry & Neurology | 1100 W 6th Ave, Gary, IN 46402-1711 | 2007-02-26 |
| 1497850663 | Kobie I Douglas | Psychiatry & Neurology | 1100 W 6th Ave, Gary, IN 46402-1711 | 2006-09-13 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1366051641 | Optimal Medical Services LLC | Psychiatry & Neurology | 10967 Allisonville Rd Ste 110b, Fishers, IN 46038-2634 | 2020-07-23 |
| 1518585462 | Tracy Lynn Genovese | Psychiatry & Neurology | 2718 Laguardia St, Portage, IN 46368-3139 | 2020-07-08 |
| 1457988107 | Quality 360 Healthcare Alliance | Psychiatry & Neurology | 12900 N Meridian St Ste 140, Carmel, IN 46032-5401 | 2020-03-24 |
| 1245707751 | Pain Management Centers of America, Psc | Psychiatry & Neurology | 5320 Weston Rd # B, Evansville, IN 47712-3701 | 2018-11-01 |
| 1932697968 | Cadience Psych LLC | Psychiatry & Neurology | 1340 Blackthorne Trl N, Plainfield, IN 46168-5603 | 2018-04-25 |
| 1841796943 | Larrilyn Louise Grant | Psychiatry & Neurology | 355 W 16th St Dept Of, Indianapolis, IN 46202-2207 | 2018-04-05 |
| 1053761460 | Joel D Hart | Psychiatry & Neurology | 147 E Us Highway 36, Lynn, IN 47355-9193 | 2016-06-16 |
| 1275995698 | Shariff F Tanious | Psychiatry & Neurology | 355 W 16th St Ste 2364, Indianapolis, IN 46202-2279 | 2016-03-24 |
| 1871966523 | Virtual Consult Md LLC | Psychiatry & Neurology | 5444 E Indiana St, Suite 109, Evansville, IN 47715-2857 | 2015-11-03 |
| 1962881318 | Kevin Gerard Masterson | Psychiatry & Neurology | 550 University Blvd # 3124, Indianapolis, IN 46202-5149 | 2015-05-19 |
| Find all providers with the same taxonomy | ||||
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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.