Individual provider Active NPI

Sydney Ann Maloy

  • Mental Health Counselor
  • Columbia City, IN
National Provider Identifier
1275358616
Registry record updated Nov 20, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
39005169A Issued in IN
Practice address
1259 E State Road 205
Columbia City, IN 46725-9492
Phone
(260) 248-8176
NPI assigned
Nov 20, 2024
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 20, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X 39005169A IN Primary

Addresses

Primary practice location

1259 E State Road 205
Columbia City, IN 46725-9492

Mailing address

2621 E Jefferson St
Warsaw, IN 46580-3880

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IN
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.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20241129000333 IN Practitioner - Mental Health Counselor 2961937875 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
39005169AINMDMental Health Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Bowen Health Inc CurrentSince Sep 22, 2024 Accepting new patients
Bowen Health Inc Current Accepting new patients

Locations

1259 E State Road 205
Columbia City, IN 46725
Phone (260) 248-8176

850 N Harrison St
Warsaw, IN 46580
Phone (219) 267-7169

2621 E Jefferson St
Warsaw, IN 46580
Phone (574) 269-0573

Organizations & group practices 2

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": "1732060800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1732060800000",
    "number": "1275358616",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2621 E JEFFERSON ST",
            "city": "WARSAW",
            "state": "IN",
            "postal_code": "465803880"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1259 E STATE ROAD 205",
            "city": "COLUMBIA CITY",
            "state": "IN",
            "postal_code": "467259492",
            "telephone_number": "260-248-8176"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MALOY",
        "first_name": "SYDNEY",
        "middle_name": "ANN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-11-20",
        "last_updated": "2024-11-20",
        "certification_date": "2024-11-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "IN",
            "license": "39005169A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Columbia City, IN

Sources for this page

Verify at the official NPI Registry.