NPIMap

Organization Active NPI

Mental Health America Wabash Valley Region Inc

  • Mental Health Counselor
  • Lafayette, IN
National Provider Identifier
1053088252
Registry record updated Jul 1, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
Legal business name
MENTAL HEALTH AMERICA WABASH VALLEY REGION INC
Practice address
914 South St
Lafayette, IN 47901-1416
Phone
(765) 742-1800
NPI assigned
Aug 25, 2021
Last updated
Jul 1, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 1, 2025

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

Authorized official

Name
Brandi Rae Christiansen
Title
President and Ceo
Phone
(765) 742-1800

Specialties & licenses 6

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) Counselor 101YA0400X
Mental Health Counselor 101YM0800X Primary
Clinical Psychologist 103TC0700X
Clinical Social Worker 1041C0700X
Driver 172A00000X
Peer Specialist 175T00000X

Addresses

Primary practice location

914 South St
Lafayette, IN 47901-1416

Mailing address

914 South St
Lafayette, IN 47901-1416
Phone (765) 742-1800

Other practice location 1

700 E Firmin St Ste 263
Kokomo, IN 46902-2340
Phone (765) 742-1800

Other practice location 2

901 Prince William Rd
Delphi, IN 46923-1758
Phone (765) 742-1800

Other names 1

  • Mental Health America of Tippecanoe County Inc Former legal business name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IN

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20250808000672 IN Part B Supplier - Clinic/Group Practice 8527566637 Receives reassigned benefits from 1 practitioner
Practice locations: Delphi, IN; Kokomo, IN; Lafayette, IN

National Provider Directory

National Provider Directory
Tax ID family
Mental Health America2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Locations

700 E Firmin St
Ste 263
Kokomo, IN 46902
Phone (765) 480-7702

Practitioners & affiliated clinicians

Practitioners 9

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1629849600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1751328000000",
    "number": "1053088252",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "914 SOUTH ST",
            "city": "LAFAYETTE",
            "state": "IN",
            "postal_code": "479011416",
            "telephone_number": "765-742-1800"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "914 SOUTH ST",
            "city": "LAFAYETTE",
            "state": "IN",
            "postal_code": "479011416",
            "telephone_number": "765-742-1800"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "700 E Firmin St Ste 263",
            "address_purpose": "LOCATION",
            "city": "Kokomo",
            "state": "IN",
            "postal_code": "469022340",
            "country_code": "US",
            "telephone_number": "765-742-1800",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "901 Prince William Rd",
            "address_purpose": "LOCATION",
            "city": "Delphi",
            "state": "IN",
            "postal_code": "469231758",
            "country_code": "US",
            "telephone_number": "765-742-1800",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "MENTAL HEALTH AMERICA WABASH VALLEY REGION INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-08-25",
        "last_updated": "2025-07-01",
        "certification_date": "2025-07-01",
        "status": "A",
        "authorized_official_last_name": "CHRISTIANSEN",
        "authorized_official_first_name": "BRANDI",
        "authorized_official_middle_name": "RAE",
        "authorized_official_title_or_position": "PRESIDENT AND CEO",
        "authorized_official_telephone_number": "765-742-1800"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "172A00000X",
            "taxonomy_group": "",
            "desc": "Driver",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "175T00000X",
            "taxonomy_group": "",
            "desc": "Peer Specialist",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Mental Health America of Tippecanoe County Inc",
            "code": "4",
            "type": "Former Legal Business Name"
        },
        {
            "organization_name": "Mental Health America of Tippecanoe County Inc",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

Other providers in Lafayette, IN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 1, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.