Dr. Sanford Lloyd Pederson
Psychologist Health Service Health Psychologist Clinical Psychologist and 4 more
494 S Emerson Ave Suite C
Greenwood
, Indiana 46143-1912
Dr. Sanford Lloyd Pederson
Psychologist Health Service Health Psychologist Clinical Psychologist and 4 more
494 S Emerson Ave Suite C
Greenwood
, Indiana 46143-1912
(317) 889-3902
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About
Features
Specialties
- Clinical Psychologist
- Psychologist
- Adult Development & Aging Psychologist
- Forensic Psychologist
- Health Psychologist
- Health Service
- Rehabilitation Psychologist
Languages spoken
- English
Location
First Address
- Dr. Sanford Lloyd Pederson
- 494 S Emerson Ave Suite C
- Greenwood, IN
- Zip : 46143-1912
- Fax : (317) 889-3902
- Phone : (317) 889-3901
Second Address
- Dr. Sanford Lloyd Pederson
- 494 S Emerson Ave Suite C
- Greenwood, IN
- Zip : 46143-1912
- Fax : (317) 889-3902
- Phone : (317) 889-3901
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FAQs
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Scope of Practice
| Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
|---|---|---|---|---|
| Y | 103G00000X | Clinical Psychologist | 20041487 | IN |
| Y | 103TC0700X | Clinical Psychologist | 20041487 | IN |
| N | 102L00000X | Psychologist | 20041487 | IN |
| N | 103T00000X | Psychologist | 20041487 | IN |
| N | 103TA0700X | Adult Development & Aging Psychologist | 20041487 | IN |
| N | 103G00000X | Clinical Psychologist | 20041487 | IN |
| N | 103TC0700X | Clinical Psychologist | 20041487 | IN |
| N | 103TF0200X | Forensic Psychologist | 20041487 | IN |
| N | 103TH0004X | Health Psychologist | 20041487 | IN |
| N | 103TH0100X | Health Service | 20041487 | IN |
| N | 103TR0400X | Rehabilitation Psychologist | 20041487 | IN |
National Provider Identifier
| NPI | 1659589885 |
|---|---|
| Provider Name | Dr. Sanford Lloyd Pederson |
| First Address | Greenwood, IN 46143-1912 |
| Second Address | Greenwood, IN 46143-1912 |
| Gender | M |
| NPI Entity type | Individual |
| Is Sole Proprietor | No |
| Is Organization Subpart | N/A |
| Enumeration Date | 20/05/2007 |
| Last Update Date | 19/03/2020 |
Additional Identifiers
| IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
|---|---|---|
| 200227370 | (05) | IN |
| 225420 | MEDICATE PTAN (01) | |
| 225420A | MEDICARE LEGACY ID (01) | |
| S89637 | (02) | IN |
NPI Footnotes
What is the National Provider Identifier (NPI)
Provider Location Address
Provider Mailing Address
Entity Type Code
1= Person: individual human being who furnishes health care;
2= Non-person: entity other than an individual human being that furnishes health care (Examples: hospital, SNF, hospital subunit, pharmacy, or HMO)
What is a Subpart?
Provider Other Organization Name
1 = former name;
2 = professional name;
3 = doinq business as (d/b/ a) name;
4 = former legal business name;
5 = other.