Mary Mirro, Psy. D., Hspp, LLC
NPI 1114059953ActiveOrganization· Psychologist, Clinical· Crown Point, IN
Psychologist, Clinical in Crown Point, Indiana, registered in NPPES in March 2007. The authorized official on file is Mary Mirro, PSY D, Psychologist/Owner. Enrolled in Medicare as part b supplier - clinic/group practice.
Overview
| NPI | 1114059953 |
|---|---|
| Status | Active |
| Entity type | Organization |
| NPI issued | Mar 9, 2007 |
| Last updated in NPPES | Dec 21, 2022 |
| Certified by provider | Dec 21, 2022 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| Psychologist, Clinical Primary | 103TC0700X | 20041970A | IN |
Exclusion screening
| List | Result | Details |
|---|---|---|
| HHS-OIG LEIE · Nov 10, 2026 | No match | Checked by NPI and by name + state |
| North Carolina Medicaid · Nov 11, 2026 | No match | — |
| New York OMIG · Nov 11, 2026 | No match | — |
| Ohio Medicaid · Nov 11, 2026 | No match | — |
| Pennsylvania Medicheck · Nov 11, 2026 | No match | — |
| Washington HCA · Nov 11, 2026 | No match | — |
Official OIG search · How matching works ·Bulk check a roster
Medicare
| Enrollment (PECOS) | Enrolled Part B Supplier - Clinic/Group Practice (IN) |
|---|
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