Organization Active NPI

Joyful Alegria LLC

  • Marriage & Family Therapist
  • Portage, IN
National Provider Identifier
1104514512
Registry record updated Apr 29, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
Legal business name
JOYFUL ALEGRIA LLC
Practice address
2545 Blake Rd
Portage, IN 46368-1817
Phone
(219) 413-1817
NPI assigned
Apr 25, 2023
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 29, 2023

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

Authorized official

Name
Yolanda Casillas, PHD
Title
Founder
Phone
(219) 487-4388

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Marriage & Family TherapistGroup: 193200000X MULTI-SPECIALTY GROUP 106H00000X Primary

Addresses

Primary practice location

2545 Blake Rd
Portage, IN 46368-1817

Mailing address

2545 Blake Rd
Portage, IN 46368-1817
Phone (219) 413-1817

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL, IN2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20240410002980 IL Part B Supplier - Clinic/Group Practice 9739527664 Receives reassigned benefits from 1 practitioner
Practice locations: Chicago, IL
O20251227000483 IN Part B Supplier - Clinic/Group Practice 9739527664 Receives reassigned benefits from 1 practitioner
Practice locations: Portage, IN

National Provider Directory

National Provider Directory

Locations

5120 Central Ave
Portage, IN 46368
Phone (219) 487-4388

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1682380800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1682726400000",
    "number": "1104514512",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2545 BLAKE RD",
            "city": "PORTAGE",
            "state": "IN",
            "postal_code": "463681817",
            "telephone_number": "219-413-1817"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2545 BLAKE RD",
            "city": "PORTAGE",
            "state": "IN",
            "postal_code": "463681817",
            "telephone_number": "219-413-1817"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JOYFUL ALEGRIA LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-04-25",
        "last_updated": "2023-04-29",
        "certification_date": "2023-04-29",
        "status": "A",
        "authorized_official_last_name": "CASILLAS",
        "authorized_official_first_name": "YOLANDA",
        "authorized_official_title_or_position": "FOUNDER",
        "authorized_official_telephone_number": "219-487-4388",
        "authorized_official_credential": "PHD"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Marriage & Family Therapist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Portage, IN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 29, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.