Individual provider Active NPI

Sydney Vander Tuin

  • Marriage & Family Therapist
  • Valparaiso, IN
National Provider Identifier
1144839333
Registry record updated Aug 24, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
Practice address
1551 Sturdy Rd Ste 3
Valparaiso, IN 46383-7829
Phone
(219) 531-0111
NPI assigned
Jul 23, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 24, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Marriage & Family Therapist 106H00000X Primary

Addresses

Primary practice location

1551 Sturdy Rd Ste 3
Valparaiso, IN 46383-7829

Mailing address

1551 Sturdy Rd Ste 3
Valparaiso, IN 46383-7829

Other practice location 1

1308 N Main St
Crown Point, IN 46307-2719
Phone (219) 508-0629

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
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.

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Shannon Johnson LLC Marriage & Family Therapist CurrentSince Aug 29, 2021 Accepting new patients

Locations

1551 Sturdy Rd
Ste 3
Valparaiso, IN 46383
Phone (219) 531-0111

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": "1595462400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1629763200000",
    "number": "1144839333",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1551 STURDY RD STE 3",
            "city": "VALPARAISO",
            "state": "IN",
            "postal_code": "463837829"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1551 STURDY RD STE 3",
            "city": "VALPARAISO",
            "state": "IN",
            "postal_code": "463837829",
            "telephone_number": "219-531-0111"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1308 N Main St",
            "address_purpose": "LOCATION",
            "city": "Crown Point",
            "state": "IN",
            "postal_code": "463072719",
            "country_code": "US",
            "telephone_number": "219-508-0629",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "VANDER TUIN",
        "first_name": "SYDNEY",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-07-23",
        "last_updated": "2021-08-24",
        "certification_date": "2021-08-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Valparaiso, IN

Sources for this page

Verify at the official NPI Registry.