Individual provider Active NPI

Jessica Lynn Neidlinger, LMHC

  • Mental Health Counselor
  • Indianapolis, IN
National Provider Identifier
1104322148
Registry record updated Jan 8, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
39003194A Issued in IN
Practice address
819 E 64TH St Ste 220
Indianapolis, IN 46220
Phone
(317) 629-8957
NPI assigned
Mar 30, 2018
Last updated
Jan 8, 2019By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 8, 2019

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Counselor 101Y00000X 39003194 IN
Mental Health Counselor 101YM0800X 39003194A IN Primary

Addresses

Primary practice location

819 E 64TH St Ste 220
Indianapolis, IN 46220

Mailing address

819 E 64TH St Ste 220
Indianapolis, IN 46220-1695
Phone (317) 629-8957

Other practice location 1

9002 N Meridian St Ste 200
Indianapolis, IN 46260-5350
Phone (317) 629-8957

Other practice location 2

9002 N Meridian St Ste 200
Indianapolis, IN 46260-5350
Phone (317) 629-8957

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
39003194INMDCounselor
39003194AINMDMental Health Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
The Palms Counseling Center LLC Counselor Past Accepting new patients

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1522368000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1546905600000",
    "number": "1104322148",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "819 E 64TH ST STE 220",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462201695",
            "telephone_number": "317-629-8957"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "819 E 64TH ST STE 220",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "46220",
            "telephone_number": "317-629-8957"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "9002 N Meridian St Ste 200",
            "address_purpose": "LOCATION",
            "city": "Indianapolis",
            "state": "IN",
            "postal_code": "462605350",
            "country_code": "US",
            "telephone_number": "317-629-8957",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "9002 N Meridian St Ste 200",
            "address_purpose": "LOCATION",
            "city": "Indianapolis",
            "state": "IN",
            "postal_code": "462605350",
            "country_code": "US",
            "telephone_number": "317-629-8957",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "NEIDLINGER",
        "first_name": "JESSICA",
        "middle_name": "LYNN",
        "credential": "LMHC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-03-30",
        "last_updated": "2019-01-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": "IN",
            "license": "39003194",
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "IN",
            "license": "39003194A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Indianapolis, IN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 8, 2019; 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.