Dockside Services, LLC

Primary specialty

Community/Behavioral Health AgencyTaxonomy code 251S00000X

Legal business name

DOCKSIDE SERVICES, LLC

Practice address

2614 Lincoln Hwy
Merrillville, IN 46410-5235

Phone

(219) 513-3960

Fax

(219) 838-8020

NPI assigned

Feb 23, 2007

Organization subpart

No

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

Authorized official

Name

Mary Mims

Title

Executive Director

Phone

(708) 903-7689

Specialties & licenses 2

Addresses

Other identifiers 1

Other names 1

• Clarvida Doing business as

Locations

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

{
    "created_epoch": "1172188800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1770249600000",
    "number": "1124154414",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2614 LINCOLN HWY",
            "city": "MERRILLVILLE",
            "state": "IN",
            "postal_code": "464105235",
            "telephone_number": "219-513-3960",
            "fax_number": "219-838-8020"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2614 LINCOLN HWY",
            "city": "MERRILLVILLE",
            "state": "IN",
            "postal_code": "464105235",
            "telephone_number": "219-513-3960",
            "fax_number": "219-838-8020"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DOCKSIDE SERVICES, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-23",
        "last_updated": "2026-02-05",
        "certification_date": "2026-02-05",
        "status": "A",
        "authorized_official_last_name": "MIMS",
        "authorized_official_first_name": "MARY",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "708-903-7689"
    },
    "taxonomies": [
        {
            "code": "251B00000X",
            "taxonomy_group": "",
            "desc": "Case Management",
            "state": "IN",
            "license": "370346298 53782",
            "primary": false
        },
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200297360A",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Clarvida",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Haley Dockery
• Alexis Dodson, RBT
• Dominique Jamison-Willams
• Maya Janay Dominique, M.D.
• Kimberly Donaghue
• Hayley Jordan Dorsett, MA, LMHC, NCC

• Community/Behavioral Health Agency in Merrillville, IN
• Providers in Merrillville, IN by specialty
• Community/Behavioral Health Agency in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 5, 2026; 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.