NPIMap

Individual provider Active NPI

Mark Alan Hostetler, LMHC, LCAC

  • Mental Health Counselor
  • Indianapolis, IN
National Provider Identifier
1134729981
Registry record updated Oct 30, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
39000022A Issued in IN
Practice address
2105 N Meridian St Ste 102
Indianapolis, IN 46202-1358
Phone
(317) 926-5463
NPI assigned
Oct 30, 2020
Last updated
Oct 30, 2020By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 30, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) Counselor 101YA0400X 87000900A IN
Mental Health CounselorGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 101YM0800X 39000022A IN Primary

Addresses

Primary practice location

2105 N Meridian St Ste 102
Indianapolis, IN 46202-1358

Mailing address

2105 N Meridian St Ste 102
Indianapolis, IN 46202-1358
Phone (317) 926-5463

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address cons.heidi@sbcglobal.net Direct

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

State licenses

LicenseStateTypeSpecialty
87000900AINMDAddiction (Substance Use Disorder) Counselor
39000022AINMDMental Health Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Community Outreach Network Services, Inc. PastSince Nov 1, 2020 Accepting new patients
Community Outreach Network Services PastSince Nov 1, 2020 Accepting new patients

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1604016000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1604016000000",
    "number": "1134729981",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2105 N MERIDIAN ST STE 102",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462021358",
            "telephone_number": "317-926-5463"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2105 N MERIDIAN ST STE 102",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462021358",
            "telephone_number": "317-926-5463"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HOSTETLER",
        "first_name": "MARK",
        "middle_name": "ALAN",
        "name_prefix": "Mr.",
        "credential": "LMHC, LCAC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2020-10-30",
        "last_updated": "2020-10-30",
        "certification_date": "2020-10-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "IN",
            "license": "87000900A",
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Counselor, Mental Health",
            "state": "IN",
            "license": "39000022A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "cons.heidi@sbcglobal.net",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "2105 N Meridian St Ste 102",
            "city": "Indianapolis",
            "state": "IN",
            "country_code": "US",
            "postal_code": "462021358",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Indianapolis, IN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 30, 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.