1952709867 NPI number — DR. KATHERINE NICOLE SCHWARTZKOPF PSYD

Table of content: DR. KATHERINE NICOLE SCHWARTZKOPF PSYD (NPI 1952709867)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1952709867 NPI number — DR. KATHERINE NICOLE SCHWARTZKOPF PSYD

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
SCHWARTZKOPF
Provider First Name:
KATHERINE
Provider Middle Name:
NICOLE
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
Provider Credential Text:
PSYD
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
DANIELS
Provider Other First Name:
KATHERINE
Provider Other Middle Name:
NICOLE
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:
1

NPI Number Information

NPI Number:
1952709867
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
02/01/2023
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 1026
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
INDIANAPOLIS
Provider Business Mailing Address State Name:
IN
Provider Business Mailing Address Postal Code:
46206-1026
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
317-777-6435
Provider Business Mailing Address Fax Number:
317-777-6644

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
705 RILEY DRIVE
Provider Second Line Business Practice Location Address:
ROC 4210
Provider Business Practice Location Address City Name:
INDIANAPOLIS
Provider Business Practice Location Address State Name:
IN
Provider Business Practice Location Address Postal Code:
46202-5109
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
317-944-3774
Provider Business Practice Location Address Fax Number:
317-944-8521
Provider Enumeration Date:
12/09/2014

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 103TC2200X , with the licence number:  20043356B , registered in the state of IN ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 103TC2200X , with the licence number: 20043356A , registered in the state of IN ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 300039766 , issued by the state of ( IN ) . This identifiers is of the category "MEDICAID".




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