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Contact Information

LIVING WELL BEHAVIORAL HEALTH, PC
1908 W LINCOLN AVE
GOSHEN, IN46526-5907
 Phone: 574-534-6150
 Fax: 574-534-8139
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Clinical

103TC0700X 62 Psychologist, Clinical
Indicates primary specialty

NPI Profile & details for LIVING WELL BEHAVIORAL HEALTH PC · (Female)

NPI # 1659477081
Status Active
Credentials
Entity Individual
Enumeration date 09/15/2006
Last updated 08/27/2008 - About 18 years ago
Sole proprietor 1 Not specified
Identifiers
  • IN License # 20042056A
  • IN Medicaid 200804500A
  • IN Medicaid 200888680
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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