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NPI Profile for LIFE STAGES THERAPY CENTER INC in FORT WAYNE, IN.
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.
Specialty |
Taxonomy Code | Specialty Code | Provider Type | |
Clinical |
103TC0700X | 62 | Psychologist, Clinical | |
Case Manager/Care Coordinator |
171M00000X | |||
Community/Behavioral Health |
251S00000X | |||
Counselor |
101Y00000X | |||
Developmental Therapist |
222Q00000X | |||
General Practice |
208D00000X | 99 | Physician/Undefined Physician type[6] | |
Marriage & Family Therapist |
106H00000X | |||
Occupational Therapist |
225X00000X | 67 | Occupational Therapist in Private Practice | |
Physical Therapist |
225100000X | 65 | Physical Therapist in Private Practice | |
School |
103TS0200X | 62 | Psychologist, Clinical | |
Social Worker |
104100000X | |||
Speech-Language Pathologist |
235Z00000X | 15 | Speech Language Pathologist |
| NPI # | 1376974378 |
|
| Status | Active | |
| Credentials | ||
| Entity | Individual | |
| Enumeration date | 12/02/2013 | |
| Last updated | 12/02/2013 - About 13 years ago | |
| Sole proprietor 1 | Not specified | |
| Identifiers |
|
|
| Hospital affiliation(s) | Not Available |
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LIFE STAGES THERAPY CENTER, INC
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LIFE STAGES THERAPY CENTER, INC