Active NPI
Jerry Alan Summerfield, LMHC
- Mental Health Counselor
- Jeffersonville, IN
National Provider Identifier
1073859963
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Mental Health Counselor
- License
- 39003597A
- 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
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| 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
| Identifier | Type | State | Issuer |
|---|---|---|---|
| MH13868 | Other | FL | STATE OF FLORIDA |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in IN, FL
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: No
- Power mobility devices: No
- Hospice: No
Enrollment records 2
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
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
| License | State | Type | Specialty |
|---|---|---|---|
| MH13868 | FL | MD | Mental Health Counselor |
| 39003597A | IN | MD | Mental 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
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 8, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.