Provider Demographics
NPI:1548334485
Name:KARCH, GREGORY ROBERT (PHD HSPP)
Entity type:Individual
Prefix:DR
First Name:GREGORY
Middle Name:ROBERT
Last Name:KARCH
Suffix:
Gender:M
Credentials:PHD HSPP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:245 S 4TH ST
Mailing Address - Street 2:STE A
Mailing Address - City:RICHMOND
Mailing Address - State:IN
Mailing Address - Zip Code:47374-5475
Mailing Address - Country:US
Mailing Address - Phone:765-935-7284
Mailing Address - Fax:765-935-5002
Practice Address - Street 1:1901 E MAIN ST
Practice Address - Street 2:
Practice Address - City:RICHMOND
Practice Address - State:IN
Practice Address - Zip Code:47374-5707
Practice Address - Country:US
Practice Address - Phone:765-935-7284
Practice Address - Fax:765-935-5002
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-20
Last Update Date:2021-03-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN20090236A103TA0400X, 103TB0200X, 103TC1900X, 103TF0000X, 103TP2701X, 103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist
No103TA0400XBehavioral Health & Social Service ProvidersPsychologistAddiction (Substance Use Disorder)
No103TB0200XBehavioral Health & Social Service ProvidersPsychologistCognitive & Behavioral
No103TC1900XBehavioral Health & Social Service ProvidersPsychologistCounseling
No103TF0000XBehavioral Health & Social Service ProvidersPsychologistFamily
No103TP2701XBehavioral Health & Social Service ProvidersPsychologistGroup Psychotherapy
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN100257260AMedicaid
IN100257260AMedicaid
IN905050Medicare ID - Type Unspecified