Active NPI
Darlene June Freeman, LMHC
- Mental Health Counselor
- South Bend, IN
National Provider Identifier
1285776401
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Mental Health Counselor
- License
- 39000312A
- Practice address
- 3603 E Jefferson Blvd
South Bend, IN 46615-3035 - Phone
- (574) 287-7323
- Fax
- (574) 287-7365
- NPI assigned
- Feb 13, 2007
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | 39000312A | IN | Primary |
| Mental Health Counselor | 101YM0800X | 6401004440 | MI |
Addresses
Primary practice location
3603 E Jefferson Blvd
South Bend, IN 46615-3035
Mailing address
403 N Greene Rd
Goshen, IN 46526-1307
Phone (574) 533-5146
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 39000312A | IN | MD | Mental Health Counselor |
| 6401004440 | MI | MD | Mental Health Counselor |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Infinity Behavioral Systems LLC | Past | Accepting new patients |
Organizations & group practices 1
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.
-
- Community/Behavioral Health Agency
- South Bend, IN
- NPI 1013361294
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1171324800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1285776401",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "403 N GREENE RD",
"city": "GOSHEN",
"state": "IN",
"postal_code": "465261307",
"telephone_number": "574-533-5146"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3603 E JEFFERSON BLVD",
"city": "SOUTH BEND",
"state": "IN",
"postal_code": "466153035",
"telephone_number": "574-287-7323",
"fax_number": "574-287-7365"
}
],
"practiceLocations": [],
"basic": {
"last_name": "FREEMAN",
"first_name": "DARLENE",
"middle_name": "JUNE",
"name_prefix": "Mrs.",
"credential": "LMHC",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2007-02-13",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": "IN",
"license": "39000312A",
"primary": true
},
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": "MI",
"license": "6401004440",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in South Bend, IN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.