Provider Demographics
NPI:1063585826
Name:BELINDA LEWIS HUBERT PHD, FPPR, INC
Entity type:Organization
Organization Name:BELINDA LEWIS HUBERT PHD, FPPR, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:BELINDA
Authorized Official - Middle Name:L
Authorized Official - Last Name:HUBERT
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:219-696-2859
Mailing Address - Street 1:17317 WHITE OAK AVE
Mailing Address - Street 2:
Mailing Address - City:LOWELL
Mailing Address - State:IN
Mailing Address - Zip Code:46356-9411
Mailing Address - Country:US
Mailing Address - Phone:219-696-2859
Mailing Address - Fax:219-696-1745
Practice Address - Street 1:17317 WHITE OAK AVE
Practice Address - Street 2:
Practice Address - City:LOWELL
Practice Address - State:IN
Practice Address - Zip Code:46356-9411
Practice Address - Country:US
Practice Address - Phone:219-696-2859
Practice Address - Fax:219-696-1745
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:BELINDA LEWIS HUBERT PHD, FPPR, INC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2006-11-17
Last Update Date:2010-11-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
INHSPP20040912103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN100465150AMedicaid
IN874180Medicare ID - Type Unspecified