Provider Demographics
NPI:1043029861
Name:SOMMER PSYCHOLOGY GROUP
Entity type:Organization
Organization Name:SOMMER PSYCHOLOGY GROUP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEMBER/DIRECTOR OF OPERATION
Authorized Official - Prefix:
Authorized Official - First Name:SAMUEL
Authorized Official - Middle Name:A
Authorized Official - Last Name:BURNS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:317-627-8154
Mailing Address - Street 1:8465 KEYSTONE XING STE 115
Mailing Address - Street 2:#752
Mailing Address - City:INDIANAPOLIS
Mailing Address - State:IN
Mailing Address - Zip Code:46240-2453
Mailing Address - Country:US
Mailing Address - Phone:317-520-8338
Mailing Address - Fax:
Practice Address - Street 1:69 N WHITTIER PL
Practice Address - Street 2:
Practice Address - City:INDIANAPOLIS
Practice Address - State:IN
Practice Address - Zip Code:46219-5713
Practice Address - Country:US
Practice Address - Phone:812-320-6652
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-01-06
Last Update Date:2025-01-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TP2701XBehavioral Health & Social Service ProvidersPsychologistGroup PsychotherapyGroup - Multi-Specialty