NPIMap

Organization Active NPI

PHD Mentoring Services, LLC

  • Mental Health Counselor
  • Indianapolis, IN
National Provider Identifier
1245999150
Registry record updated Dec 8, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
Legal business name
PHD MENTORING SERVICES, LLC
Doing business as
PHD Mentoring Services, LLC
Practice address
8218 St Clifford CT
Indianapolis, IN 46239-8996
Phone
(317) 667-8409
NPI assigned
Dec 8, 2021
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 8, 2021

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

Authorized official

Name
Mr. Clarence Martin Jr.NPI 1093110348
Title
Owner/Authorized Official
Phone
(317) 667-8409

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: 193400000X SINGLE SPECIALTY GROUP 101YM0800X Primary

Addresses

Primary practice location

8218 St Clifford CT
Indianapolis, IN 46239-8996

Mailing address

8218 St Clifford CT
Indianapolis, IN 46239-8996
Phone (317) 667-8409

Other names 1

  • PHD Mentoring Services, LLC Doing business as

National Provider Directory

National Provider Directory

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": "1638921600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1638921600000",
    "number": "1245999150",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8218 ST CLIFFORD CT",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462398996",
            "telephone_number": "317-667-8409"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8218 ST CLIFFORD CT",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462398996",
            "telephone_number": "317-667-8409"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PHD MENTORING SERVICES, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-12-08",
        "last_updated": "2021-12-08",
        "certification_date": "2021-12-08",
        "status": "A",
        "authorized_official_last_name": "MARTIN",
        "authorized_official_first_name": "CLARENCE",
        "authorized_official_title_or_position": "OWNER/AUTHORIZED OFFICIAL",
        "authorized_official_telephone_number": "317-667-8409",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_name_suffix": "Jr."
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "PHD Mentoring Services, LLC",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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 Dec 8, 2021; 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.