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MARY ANN NUSBAUM PHD NPI 1720351117


NPI Information

NPI: 1720351117
Provider Name: MARY ANN NUSBAUM, PHD
Classification: Psychologist - 103TC0700X
Entity Type: Individual

Specialization: Clinical

Address:
4738 W COUNTY ROAD 400 S
LOGANSPORT, IN
ZIP 46947
Phone: (574) 339-9277
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Mary Ann Nusbaum, PHD is a clinical psychologist in Logansport, IN. The provider is a psychologist who provides continuing and comprehensive mental and behavioral health care for individuals and families; consultation to agencies and communities; training, education and supervision; and research-based practice. It is a specialty in breadth -- one that is broadly inclusive of severe psychopathology -- and marked by comprehensiveness and integration of knowledge and skill from a broad array of disciplines within and outside of psychology proper. The scope of clinical psychology encompasses all ages, multiple diversities and varied systems. Mary Ann Nusbaum, PHD NPI is 1720351117. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a female.

The provider's business location address is:

4738 W COUNTY ROAD 400 S
LOGANSPORT, IN
ZIP 46947-371
Phone: (574) 339-9277

The enumeration date for this NPI number is 2/15/2012 and was last updated on 2/15/2012.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1103TC0700XPsychologistClinical20042168AINDIANAYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
120042168AOTHERINDIANAPROFESSIONAL LICENSE

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

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