North Star Services, LLC

Primary specialty

PsychologistTaxonomy code 103T00000X

Legal business name

NORTH STAR SERVICES, LLC

Practice address

425 Joliet St
Suite 309
Dyer, IN 46311-1765

Phone

(219) 322-9904

Fax

(219) 322-9956

NPI assigned

Jun 1, 2010

Last updated

Jun 1, 2010By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Kelly Jackson, MSW

Title

Member

Phone

(219) 322-9904

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1275350400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1275350400000",
    "number": "1053630087",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "425 JOLIET ST",
            "address_2": "SUITE 309",
            "city": "DYER",
            "state": "IN",
            "postal_code": "463111765",
            "telephone_number": "219-322-9904",
            "fax_number": "219-322-9956"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "425 JOLIET ST",
            "address_2": "SUITE 309",
            "city": "DYER",
            "state": "IN",
            "postal_code": "463111765",
            "telephone_number": "219-322-9904",
            "fax_number": "219-322-9956"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NORTH STAR SERVICES, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-06-01",
        "last_updated": "2010-06-01",
        "status": "A",
        "authorized_official_last_name": "JACKSON",
        "authorized_official_first_name": "KELLY",
        "authorized_official_title_or_position": "MEMBER",
        "authorized_official_telephone_number": "219-322-9904",
        "authorized_official_credential": "MSW"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 1, 2010; 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.