NPIMap

Organization Active NPI

Harbor Lights Therapy

  • Mental Health Counselor
  • Muncie, IN
National Provider Identifier
1245402783
Registry record updated Sep 10, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
39001395A Issued in IN
Legal business name
HARBOR LIGHTS THERAPY
Practice address
610 S Tillotson Ave
Suite 101
Muncie, IN 47304-4430
Phone
(765) 744-9597
NPI assigned
Mar 25, 2008
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 10, 2013

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

Authorized official

Name
Ms. Tamara Lee Imel, LMHCNPI 1669450755
Title
Owner
Phone
(765) 281-1300

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health CounselorGroup: 193200000X MULTI-SPECIALTY GROUP 101YM0800X 39001395A IN Primary

Addresses

Primary practice location

610 S Tillotson Ave
Suite 101
Muncie, IN 47304-4430

Mailing address

610 S Tillotson Ave
Suite 101
Muncie, IN 47304-4430
Phone (765) 744-9597

National Provider Directory

National Provider Directory

Locations

610 S Tillotson Ave
Ste 101
Muncie, IN 47304
Phone (765) 744-9597

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1206403200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1378771200000",
    "number": "1245402783",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "610 S TILLOTSON AVE",
            "address_2": "SUITE 101",
            "city": "MUNCIE",
            "state": "IN",
            "postal_code": "473044430",
            "telephone_number": "765-744-9597"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "610 S TILLOTSON AVE",
            "address_2": "SUITE 101",
            "city": "MUNCIE",
            "state": "IN",
            "postal_code": "473044430",
            "telephone_number": "765-744-9597"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HARBOR LIGHTS THERAPY",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-03-25",
        "last_updated": "2013-09-10",
        "status": "A",
        "authorized_official_last_name": "IMEL",
        "authorized_official_first_name": "TAMARA",
        "authorized_official_middle_name": "LEE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "765-281-1300",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "LMHC"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Mental Health",
            "state": "IN",
            "license": "39001395A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Muncie, IN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 10, 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.

Verify at the official NPI Registry.