Lakeshore Psychiatry & Wellness
Nurse Practitioner, Psych/Mental Health in Gary, IN. Organization (NPI-2).
NPI number1093635682
StatusActive
Last updated in NPPESJul 28, 2026
Details
- NPI
- 1093635682
- Entity type
- Organization (NPI-2)
- Legal business name
- Lakeshore Psychiatry & Wellness
- Organization subpart
- No
- Enumeration date
- Jul 15, 2026
- Certification date
- Jul 28, 2026
- Last updated
- Jul 28, 2026
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 363LP0808X | Nurse Practitioner, Psych/Mental Health | – | – | Yes |
| 363LF0000X | Nurse Practitioner, Family | – | – |
Practice location
201 E 5th Ave Ste AGary, IN 46402-1300
Phone 219-791-3512 · Fax 877-349-7157
Mailing address
201 E 5th Ave Ste AGary, IN 46402-1300
Phone 219-791-3512 · Fax 877-349-7157
Authorized official
Channae Watkins
Pmhnp
2197913512
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