Provider Demographics
NPI:1154338341
Name:COUVILLION, PATRICIA M (PHD)
Entity type:Individual
Prefix:DR
First Name:PATRICIA
Middle Name:M
Last Name:COUVILLION
Suffix:
Gender:F
Credentials:PHD
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Mailing Address - Street 1:9240 N MERIDIAN ST
Mailing Address - Street 2:STE 320
Mailing Address - City:INDIANAPOLIS
Mailing Address - State:IN
Mailing Address - Zip Code:46260-1822
Mailing Address - Country:US
Mailing Address - Phone:317-844-7489
Mailing Address - Fax:317-581-1007
Practice Address - Street 1:10293 N MERIDIAN ST
Practice Address - Street 2:SUITE 375
Practice Address - City:INDIANAPOLIS
Practice Address - State:IN
Practice Address - Zip Code:46290-1123
Practice Address - Country:US
Practice Address - Phone:317-581-2288
Practice Address - Fax:317-581-2295
Is Sole Proprietor?:No
Enumeration Date:2006-08-01
Last Update Date:2019-10-31
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
IN20040357103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN100128810AMedicaid
IN100128810AMedicaid