Emily Waldo, MS, NCC, LMHC

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

39004430A Issued in IN

Practice address

6337 Central Ave
Portage, IN 46368-3801

Phone

(219) 763-1499

NPI assigned

Mar 22, 2023

Last updated

Mar 22, 2023By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Science

State licenses

Practice roles

Locations

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.

• Parks Associates, P.C.

  • Clinical Psychologist
  • Portage, IN
  • NPI 1518126721
  NPD
• Shifting Tides, LLC

  • Clinical Psychologist
  • Portage, IN
  • NPI 1194965392
  NPD (past)

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

{
    "created_epoch": "1679443200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1679443200000",
    "number": "1043913932",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "955 S COUNTY LINE RD",
            "city": "WESTVILLE",
            "state": "IN",
            "postal_code": "463919500",
            "telephone_number": "219-617-8644"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6337 CENTRAL AVE",
            "city": "PORTAGE",
            "state": "IN",
            "postal_code": "463683801",
            "telephone_number": "219-763-1499"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WALDO",
        "first_name": "EMILY",
        "credential": "MS, NCC, LMHC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2023-03-22",
        "last_updated": "2023-03-22",
        "certification_date": "2023-03-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "IN",
            "license": "39004430A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Michael Anthony Villanueva, DC
• Vitas Healthcare Corporation Midwest
• Gayle Marie Voight-Block, FNP
• Wal-Mart Stores East LP (Wal-Mart Pharmacy 10-2544)
• Wal-Mart Stores East, LP (Vision Center 30-2544)
• Frank Michael Walerko, DDS
• Walgreen Co (Walgreens #13949)
• Walgreen Co (Walgreens #04560)
• Megan K Walker
• Kathryn Mary Wallace, APRN, BC

• Mental Health Counselor in Portage, IN
• Providers in Portage, IN by specialty
• Mental Health Counselor in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 22, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.