NPIMap

Organization Active NPI

Community and Family Resource Center

  • Mental Health Counselor
  • Lafayette, IN
National Provider Identifier
1174649552
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
39001705A Issued in IN
Legal business name
COMMUNITY AND FAMILY RESOURCE CENTER
Practice address
100 Saw Mill Rd Ste 3200
Lafayette, IN 47905-5597
Phone
(765) 742-4848
Fax
(765) 477-9905
NPI assigned
Mar 21, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Mr. Peter Richard Desmangles, MS, NCC, LMHC, ACIT
Title
Clinical Coordinator
Phone
(765) 742-4848

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health CounselorGroup: 193400000X SINGLE SPECIALTY GROUP 101YM0800X 39001705A IN Primary

Addresses

Primary practice location

100 Saw Mill Rd Ste 3200
Lafayette, IN 47905-5597

Mailing address

100 Saw Mill Rd Ste 3200
PO Box 1186
Lafayette, IN 47905-5597
Phone (765) 742-4848

National Provider Directory

National Provider Directory
Tax ID family
Community and Family Resource Center - the Counseling Center5 organizations share this tax ID, including this one

Other organizations with this tax ID 4

Organizations that report the same tax identification number in the National Provider Directory.

NPI Registry JSON

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

{
    "created_epoch": "1174435200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1174649552",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 SAW MILL RD STE 3200",
            "address_2": "PO BOX 1186",
            "city": "LAFAYETTE",
            "state": "IN",
            "postal_code": "479055597",
            "telephone_number": "765-742-4848",
            "fax_number": "765-477-9905"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 SAW MILL RD STE 3200",
            "city": "LAFAYETTE",
            "state": "IN",
            "postal_code": "479055597",
            "telephone_number": "765-742-4848",
            "fax_number": "765-477-9905"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COMMUNITY AND FAMILY RESOURCE CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-21",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "DESMANGLES",
        "authorized_official_first_name": "PETER",
        "authorized_official_middle_name": "RICHARD",
        "authorized_official_title_or_position": "CLINICAL COORDINATOR",
        "authorized_official_telephone_number": "765-742-4848",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "MS, NCC, LMHC, ACIT"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Counselor, Mental Health",
            "state": "IN",
            "license": "39001705A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lafayette, IN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 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.