NPIMap

Organization Active NPI

Breaking Walls Counseling

  • Clinical Social Worker
  • Greenwood, IN
National Provider Identifier
1053788588
Registry record updated Sep 1, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
34006163A Issued in IN
Legal business name
BREAKING WALLS COUNSELING
Practice address
1079 Woodfield CT
Greenwood, IN 46143-6846
Phone
(317) 701-3384
Fax
(317) 869-4398
NPI assigned
Sep 1, 2015
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 1, 2015

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

Authorized official

Name
Mason Gallmeyer
Title
Owner
Phone
(317) 701-3384

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social WorkerGroup: 193400000X SINGLE SPECIALTY GROUP 1041C0700X 34006163A IN Primary

Addresses

Primary practice location

1079 Woodfield CT
Greenwood, IN 46143-6846

Mailing address

1079 Woodfield Court
Greenwood, IN 46143
Phone (317) 701-3384

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1441065600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1441065600000",
    "number": "1053788588",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1079 WOODFIELD COURT",
            "city": "GREENWOOD",
            "state": "IN",
            "postal_code": "46143",
            "telephone_number": "317-701-3384",
            "fax_number": "317-869-4398"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1079 WOODFIELD CT",
            "city": "GREENWOOD",
            "state": "IN",
            "postal_code": "461436846",
            "telephone_number": "317-701-3384",
            "fax_number": "317-869-4398"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BREAKING WALLS COUNSELING",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-09-01",
        "last_updated": "2015-09-01",
        "status": "A",
        "authorized_official_last_name": "GALLMEYER",
        "authorized_official_first_name": "MASON",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "317-701-3384"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Social Worker, Clinical",
            "state": "IN",
            "license": "34006163A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Greenwood, IN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 1, 2015; 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.