Provider Demographics
NPI:1528843950
Name:MERIDIAN PSYCHOLOGICAL ASSOCIATES
Entity type:Organization
Organization Name:MERIDIAN PSYCHOLOGICAL ASSOCIATES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PSYCHOLOGIST
Authorized Official - Prefix:DR
Authorized Official - First Name:MELISSA
Authorized Official - Middle Name:K
Authorized Official - Last Name:PUTHRAN
Authorized Official - Suffix:
Authorized Official - Credentials:PSYD
Authorized Official - Phone:317-432-4131
Mailing Address - Street 1:14550 OVERBROOK DR
Mailing Address - Street 2:
Mailing Address - City:CARMEL
Mailing Address - State:IN
Mailing Address - Zip Code:46074-7727
Mailing Address - Country:US
Mailing Address - Phone:317-432-4131
Mailing Address - Fax:
Practice Address - Street 1:4401 CENTRAL AVE
Practice Address - Street 2:
Practice Address - City:INDIANAPOLIS
Practice Address - State:IN
Practice Address - Zip Code:46205-1822
Practice Address - Country:US
Practice Address - Phone:317-923-2333
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-08-24
Last Update Date:2023-08-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Single Specialty