Nusource Educational Service

Primary specialty

Mental Health Clinic/Center (Including Community Mental Health Center)Taxonomy code 261QM0801X

Legal business name

NUSOURCE EDUCATIONAL SERVICE

Practice address

4270 Ohio St
Gary, IN 46409-2006

Phone

(219) 980-6217

Fax

(219) 985-8772

NPI assigned

Oct 17, 2006

Organization subpart

No

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

Authorized official

Name

Miss Katherlyn Thedford

Title

Chief of Operations

Phone

(219) 980-6217

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1161043200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1124108733",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4270 OHIO ST",
            "city": "GARY",
            "state": "IN",
            "postal_code": "464092006",
            "telephone_number": "219-980-6217",
            "fax_number": "219-985-8772"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4270 OHIO ST",
            "city": "GARY",
            "state": "IN",
            "postal_code": "464092006",
            "telephone_number": "219-980-6217",
            "fax_number": "219-985-8772"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NUSOURCE EDUCATIONAL SERVICE",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-17",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "THEDFORD",
        "authorized_official_first_name": "KATHERLYN",
        "authorized_official_title_or_position": "CHIEF OF OPERATIONS",
        "authorized_official_telephone_number": "219-980-6217",
        "authorized_official_name_prefix": "Miss"
    },
    "taxonomies": [
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Mental Health Clinic/Center (Including Community Mental Health Center) in Gary, IN
• Providers in Gary, IN by specialty
• Mental Health Clinic/Center (Including Community Mental Health Center) in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.