Individual provider Active NPI

Jerry Alan Summerfield, LMHC

  • Mental Health Counselor
  • Jeffersonville, IN
National Provider Identifier
1073859963
Registry record updated Aug 8, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
39003597A Issued in IN
Practice address
601 N Shore Dr Ste 202
Jeffersonville, IN 47130-3145
Phone
(812) 913-7200
NPI assigned
Dec 20, 2012
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 8, 2025

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) Counselor 101YA0400X
Mental Health Counselor 101YM0800X MH13868 FL
Mental Health Counselor 101YM0800X 39003597A IN Primary

Addresses

Primary practice location

601 N Shore Dr Ste 202
Jeffersonville, IN 47130-3145

Mailing address

245 Cherry St Apt a
New Albany, IN 47150-4806
Phone (812) 913-7200

Other identifiers 1

IdentifierTypeStateIssuer
MH13868OtherFLSTATE OF FLORIDA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IN, FL2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20260413001941 IN Practitioner - Mental Health Counselor 0143795641 Reassigns benefits to 1 organization
I20260416004145 FL Practitioner - Mental Health Counselor 0143795641 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Sondermind Provider Network LLCGroup PAC ID 9537572490, 1,295 clinicians

Practice addresses (Care Compare)

333 N Alabama St
Suite 350
Indianapolis, IN 46204-2275
Phone (866) 630-0966

333 SE 2ND Ave
Suite 2000
Miami, FL 33131-2185
Phone (866) 630-0966

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
MH13868FLMDMental Health Counselor
39003597AINMDMental Health Counselor

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1355961600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1754611200000",
    "number": "1073859963",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "245 CHERRY ST APT A",
            "city": "NEW ALBANY",
            "state": "IN",
            "postal_code": "471504806",
            "telephone_number": "812-913-7200"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "601 N SHORE DR STE 202",
            "city": "JEFFERSONVILLE",
            "state": "IN",
            "postal_code": "471303145",
            "telephone_number": "812-913-7200"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SUMMERFIELD",
        "first_name": "JERRY",
        "middle_name": "ALAN",
        "credential": "LMHC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2012-12-20",
        "last_updated": "2025-08-08",
        "certification_date": "2025-08-08",
        "status": "A"
    },
    "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": "FL",
            "license": "MH13868",
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "IN",
            "license": "39003597A",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE OF FLORIDA",
            "identifier": "MH13868",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Jeffersonville, IN

Sources for this page

Verify at the official NPI Registry.