Individual provider Active NPI

Daniel Ryan Carter, LMHC

  • Mental Health Counselor
  • Valparaiso, IN
National Provider Identifier
1003114349
Registry record updated Oct 24, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
39002589A Issued in IN
Practice address
2004 Valparaiso St
Valparaiso, IN 46383-3138
Phone
(219) 477-5646
NPI assigned
Mar 10, 2011
Last updated
Oct 24, 2024By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 24, 2024

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X 39002589A IN Primary

Addresses

Primary practice location

2004 Valparaiso St
Valparaiso, IN 46383-3138

Mailing address

2004 Valparaiso St
Valparaiso, IN 46383-3138
Phone (219) 477-5646

Other practice location 1

1401 Kings Hwy
Winona Lake, IN 46590-1520
Phone (219) 477-5646

Other identifiers 1

IdentifierTypeStateIssuer
300059549MedicaidIN

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IN
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20231201002706 IN Practitioner - Mental Health Counselor 8820446743 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Family Concern Counseling Incorporated Mental Health CurrentSince Jan 1, 2024 Accepting new patients

Locations

5775 Nimtz Pkwy
South Bend, IN 46628
Phone (219) 477-5646

2004 Valparaiso St
Valparaiso, IN 46383
Phone (219) 464-1089

1401 Kings Hwy
Winona Lake, IN 46590
Phone (219) 477-5646

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1299715200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1729728000000",
    "number": "1003114349",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2004 VALPARAISO ST",
            "city": "VALPARAISO",
            "state": "IN",
            "postal_code": "463833138",
            "telephone_number": "219-477-5646"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2004 VALPARAISO ST",
            "city": "VALPARAISO",
            "state": "IN",
            "postal_code": "463833138",
            "telephone_number": "219-477-5646"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1401 Kings Hwy",
            "address_purpose": "LOCATION",
            "city": "Winona Lake",
            "state": "IN",
            "postal_code": "465901520",
            "country_code": "US",
            "telephone_number": "219-477-5646",
            "fax_number": "219-728-4765",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CARTER",
        "first_name": "DANIEL",
        "middle_name": "RYAN",
        "credential": "LMHC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-03-10",
        "last_updated": "2024-10-24",
        "certification_date": "2024-10-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "IN",
            "license": "39002589A",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "300059549",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Valparaiso, IN

Sources for this page

Verify at the official NPI Registry.