NPIMap

Organization Active NPI

Four County Comprehensive Mental Health

Doing business as Four County Counseling Center

  • Registered Nurse
  • Logansport, IN
National Provider Identifier
1194895862
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered NurseTaxonomy code 163W00000X
License
28145473A Issued in IN
Legal business name
FOUR COUNTY COMPREHENSIVE MENTAL HEALTH
Doing business as
Four County Counseling Center
Practice address
1015 Michigan Ave
Logansport, IN 46947-1526
Phone
(574) 722-5151
Fax
(574) 722-9523
NPI assigned
Nov 9, 2006
Last updated
Aug 22, 2020By the provider in NPPES
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. Larry Ulrich
Title
Ceo
Phone
(574) 722-5151

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 28145473A IN Primary

Addresses

Primary practice location

1015 Michigan Ave
Logansport, IN 46947-1526

Mailing address

1015 Michigan Ave
Logansport, IN 46947-1526
Phone (574) 722-5151

Other identifiers 1

IdentifierTypeStateIssuer
28145473AOtherININ LICENSE

Other names 1

  • Four County Counseling Center Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Four County Mental HLTH Ctr4 organizations share this tax ID, including this one

Other organizations with this tax ID 3

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": "1163030400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1194895862",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1015 MICHIGAN AVE",
            "city": "LOGANSPORT",
            "state": "IN",
            "postal_code": "469471526",
            "telephone_number": "574-722-5151",
            "fax_number": "574-722-9523"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1015 MICHIGAN AVE",
            "city": "LOGANSPORT",
            "state": "IN",
            "postal_code": "469471526",
            "telephone_number": "574-722-5151",
            "fax_number": "574-722-9523"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FOUR COUNTY COMPREHENSIVE MENTAL HEALTH",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-09",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "ULRICH",
        "authorized_official_first_name": "LARRY",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "574-722-5151",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "IN",
            "license": "28145473A",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "IN LICENSE",
            "identifier": "28145473A",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Four County Counseling Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Logansport, 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.