Desiree Paddack, LMFT, LAC

Primary specialty

Marriage & Family TherapistTaxonomy code 106H00000X

License

35002155A Issued in IN

Practice address

4755 Kingsway Dr Ste 318
Indianapolis, IN 46205-1571

Phone

(317) 402-9915

NPI assigned

Mar 15, 2021

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

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

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Thrive Counseling LLC

  • Mental Health Counselor
  • Lynchburg, VA
  • NPI 1215181300

  IN

  Medicare reassignment NPD

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

{
    "created_epoch": "1615766400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1615766400000",
    "number": "1295310894",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8949 E WASHINGTON ST",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462196829",
            "telephone_number": "317-847-0747"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4755 KINGSWAY DR STE 318",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462051571",
            "telephone_number": "317-402-9915"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PADDACK",
        "first_name": "DESIREE",
        "credential": "LMFT, LAC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-03-15",
        "last_updated": "2021-03-15",
        "certification_date": "2021-03-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "IN",
            "license": "35002155A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Lisa Renee Pacheco, LMHC
• Laura A Pacholski, MD
• Senthil Packiasabapathy Kuthalingam, MD
• Cassidy Padal
• Benzy James Padanilam, MD
• Dawn N Paddock, NP
• Shirley Louise Paddock, RPH
• Nurcicek Padem, MD
• Linda Paden, DPT
• Anthony Mack Padgett, MD

• Marriage & Family Therapist in Indianapolis, IN
• Providers in Indianapolis, IN by specialty
• Marriage & Family Therapist in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 15, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.