Individual provider Active NPI

Krystal Mulzon, LMHC

  • Mental Health Counselor
  • Valparaiso, IN
National Provider Identifier
1104693779
Registry record updated Dec 5, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
39004740A Issued in IN
Practice address
601 Wall St
Valparaiso, IN 46383-2512
Phone
(219) 531-3500
NPI assigned
Dec 5, 2023
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 5, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X 39004740A IN Primary

Addresses

Primary practice location

601 Wall St
Valparaiso, IN 46383-2512

Mailing address

601 Wall St
Valparaiso, IN 46383-2512
Phone (219) 531-3500

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IN
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 1

Enrollment IDStateProvider typePAC IDDetails
I20240207002206 IN Practitioner - Mental Health Counselor 4183067036 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Porter-Starke Services IncGroup PAC ID 1951293554, 44 clinicians

Practice addresses (Care Compare)

601 Wall St
Valparaiso, IN 46383-2512
Phone (574) 772-4040

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
39004740AINMDMental Health Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Porter-Starke Services Inc. CurrentSince Jan 5, 2024 Accepting new patients
Porter-Starke Services Inc. CurrentSince Jan 5, 2024 Accepting new patients
Porter-Starke Services Inc. Past Accepting new patients
Porter-Starke Services, Inc. Past Accepting new patients
At Peace LLC Mental Health Past Accepting new patients

Locations

1230 W State Road 2
Ste B
La Porte, IN 46350
Phone (219) 362-2145

3176 Lancer St
Portage, IN 46368
Phone (219) 762-7318

3176 Lancer St
Ste B
Portage, IN 46368
Phone (219) 806-3000

601 Wall St
Valparaiso, IN 46383
Phone (219) 806-3011

Organizations & group practices 5

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": "1701734400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1701734400000",
    "number": "1104693779",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "601 WALL ST",
            "city": "VALPARAISO",
            "state": "IN",
            "postal_code": "463832512",
            "telephone_number": "219-531-3500"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "601 WALL ST",
            "city": "VALPARAISO",
            "state": "IN",
            "postal_code": "463832512",
            "telephone_number": "219-531-3500"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MULZON",
        "first_name": "KRYSTAL",
        "credential": "LMHC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-12-05",
        "last_updated": "2023-12-05",
        "certification_date": "2023-12-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "IN",
            "license": "39004740A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Valparaiso, IN

Sources for this page

Verify at the official NPI Registry.