Provider Demographics
NPI:1538429196
Name:HARRISON PSYCHOLOGICAL CONSULTATIONS, LLC
Entity type:Organization
Organization Name:HARRISON PSYCHOLOGICAL CONSULTATIONS, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:JULIE
Authorized Official - Middle Name:
Authorized Official - Last Name:HARRISON
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:317-600-1620
Mailing Address - Street 1:PO BOX 19313
Mailing Address - Street 2:
Mailing Address - City:INDIANAPOLIS
Mailing Address - State:IN
Mailing Address - Zip Code:46219-0313
Mailing Address - Country:US
Mailing Address - Phone:317-600-1620
Mailing Address - Fax:317-351-0321
Practice Address - Street 1:920 N SHADELAND AVE
Practice Address - Street 2:SUITE G-6A
Practice Address - City:INDIANAPOLIS
Practice Address - State:IN
Practice Address - Zip Code:46219-4898
Practice Address - Country:US
Practice Address - Phone:317-600-1620
Practice Address - Fax:317-351-0321
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-05-16
Last Update Date:2012-05-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN20041897A103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Single Specialty