State of Mind Therapy Services, LLC

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

Legal business name

STATE OF MIND THERAPY SERVICES, LLC

Practice address

55 Shore Dr
Portage, IN 46368-1008

Phone

(219) 230-8311

NPI assigned

Sep 22, 2023

Last updated

Nov 16, 2023By 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

Tiffany Kilroy, LMHCNPI 1679104343

Title

Owner/Therapist

Phone

(219) 230-8311

Specialties & licenses 2

Addresses

Locations

Practitioners 1

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.

• Tiffany Renate Kilroy, LMHC

  • Professional Counselor
  • Portage, IN
  • NPI 1679104343

  Mental Health

  NPD Authorized official

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

{
    "created_epoch": "1695340800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1700092800000",
    "number": "1083493761",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "709 PLAZA DR., SUITE 2 PMB 279",
            "city": "CHESTERTON",
            "state": "IN",
            "postal_code": "463041572",
            "telephone_number": "219-230-8311"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "55 SHORE DR",
            "city": "PORTAGE",
            "state": "IN",
            "postal_code": "463681008",
            "telephone_number": "219-230-8311"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "STATE OF MIND THERAPY SERVICES, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-09-22",
        "last_updated": "2023-11-16",
        "certification_date": "2023-11-16",
        "status": "A",
        "authorized_official_last_name": "KILROY",
        "authorized_official_first_name": "TIFFANY",
        "authorized_official_title_or_position": "OWNER/THERAPIST",
        "authorized_official_telephone_number": "219-230-8311",
        "authorized_official_credential": "LMHC"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Professional",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Saniya Spadling
• Stacey Spence
• Laura Stablein, FNP
• Eric Stanford, LMHC, NCC
• Miljan R Stankovic, MD
• Angela Marie Staton
• Brenda Kay Stenftenagel, D.D.S. M.S.D.
• Steven J Holm DDS Inc
• Daphne Stevenson, PT
• Kyle Stewart, PTA

• Professional Counselor in Portage, IN
• Providers in Portage, IN by specialty
• Professional Counselor in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 16, 2023; 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.