Active NPI
Judi A Phillips, MS, LMHC, LPC, NCC
- Mental Health Counselor
- Avon, IN
National Provider Identifier
1134441165
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Mental Health Counselor
- License
- 39000491A
- Practice address
- 6655 E US Highway 36
Avon, IN 46123-8923 - Phone
- (317) 272-3330
- Fax
- (317) 272-0807
- NPI assigned
- Feb 17, 2010
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | 39000491A | IN | Primary |
| Professional Counselor | 101YP2500X | 2555 | TN |
Addresses
Primary practice location
6655 E US Highway 36
Avon, IN 46123-8923
Mailing address
6655 E US Highway 36
Avon, IN 46123-8923
Phone (317) 272-3330
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Master of Science
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 39000491A | IN | MD | Mental Health Counselor |
| 2555 | TN | MD | Professional Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1266364800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1376265600000",
"number": "1134441165",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "6655 E US HIGHWAY 36",
"city": "AVON",
"state": "IN",
"postal_code": "461238923",
"telephone_number": "317-272-3330",
"fax_number": "317-272-0807"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "6655 E US HIGHWAY 36",
"city": "AVON",
"state": "IN",
"postal_code": "461238923",
"telephone_number": "317-272-3330",
"fax_number": "317-272-0807"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PHILLIPS",
"first_name": "JUDI",
"middle_name": "A",
"credential": "MS, LMHC, LPC, NCC",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2010-02-17",
"last_updated": "2013-08-12",
"status": "A"
},
"taxonomies": [
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": "IN",
"license": "39000491A",
"primary": true
},
{
"code": "101YP2500X",
"taxonomy_group": "",
"desc": "Counselor, Professional",
"state": "TN",
"license": "2555",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Avon, IN
- Peterson Psychiatric Services, LLC
- Valerie Anne Petro, P.T.
- Danielle Pfeffer, FNP
- Jennifer Pfledderer, MSW
- Paulina Tuyet Phan, PHARMD
- Physical Therapy, Inc (Avon Physical Therapy)
- Physiotherapy Associates Inc (Select Physical Therapy)
- Daisy Jo Lynn Pickett
- Judith Jane Pickett
- Geralyn Rae Pierce, MA, LMHC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 12, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.