Individual provider Active NPI

Mark Edward Lincks, LMHC

  • Mental Health Counselor
  • Indianapolis, IN
National Provider Identifier
1124781422
Registry record updated Mar 22, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
39002167A Issued in IN
Practice address
901 Shelby St
Indianapolis, IN 46203-1384
Phone
(317) 957-2070
NPI assigned
Oct 14, 2021
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 22, 2024

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 39002167A IN Primary

Addresses

Primary practice location

901 Shelby St
Indianapolis, IN 46203-1384

Mailing address

6531 Woodcrest Dr
Avon, IN 46123-7301
Phone (317) 403-1207

Other identifiers 1

IdentifierTypeStateIssuer
300056279MedicaidIN

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
I20240524001065 IN Practitioner - Mental Health Counselor 8022455864 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 1992
Medicare assignment
May accept Medicare assignment
Group practices
Healthnet IncGroup PAC ID 7214840933, 77 clinicians

Practice addresses (Care Compare)

2855 N Keystone Ave
Suite 120
Indianapolis, IN 46218-2790

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Healthnet, Inc. CurrentSince Apr 17, 2024 Accepting new patients

Locations

3401 E Raymond St
#0
Indianapolis, IN 46203

3403 E Raymond St
Indianapolis, IN 46203
Phone (317) 957-2000

901 Shelby St
Indianapolis, IN 46203
Phone (317) 488-2040

1701 Senate Blvd
Indianapolis, IN 46202
Phone (317) 612-2754

2855 N Keystone Ave
Ste 130
Indianapolis, IN 46218

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1634169600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1711065600000",
    "number": "1124781422",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6531 WOODCREST DR",
            "city": "AVON",
            "state": "IN",
            "postal_code": "461237301",
            "telephone_number": "317-403-1207"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "901 SHELBY ST",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462031384",
            "telephone_number": "317-957-2070"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LINCKS",
        "first_name": "MARK",
        "middle_name": "EDWARD",
        "name_prefix": "Mr.",
        "credential": "LMHC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-10-14",
        "last_updated": "2024-03-22",
        "certification_date": "2024-03-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "IN",
            "license": "39002167A",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "300056279",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Indianapolis, IN

Sources for this page

Verify at the official NPI Registry.