Individual provider · Type 1 NPI
Leroy Burgess, PSYCHOLOGIST
Health Service Psychologist · South Bend, IN
Practice location
300 S Saint Louis Blvd Ste 202
South Bend, IN 46617-3044
Fax (574) 232-0124
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Health Service Psychologist Primary | 103TH0100X | 99066271A (IN) |
Health Service Psychologist: A psychologist, certified/licensed at the independent practice level in his/her state, who is duly trained and experienced in the delivery of direct, preventative, assessment, and therapeutic intervention services to individuals whose growth, adjustment, or functioning is actually impaired or is demonstrably at high risk of impairment (1974).
Other health service psychologist providers in South Bend
About NPI 1528449964
Leroy Burgess, PSYCHOLOGIST's National Provider Identifier is 1528449964, issued on Jun 11, 2015. The primary taxonomy on file is Health Service Psychologist (103TH0100X), and the practice location is in South Bend, IN. The record was last updated on Jun 11, 2015.