Individual provider Active NPI

Charisma Mabry

  • Mental Health Counselor
  • Merrillville, IN
National Provider Identifier
1306492103
Registry record updated Aug 16, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
Practice address
8200 Georgia St
Merrillville, IN 46410-6227
Phone
(219) 791-1400
NPI assigned
Aug 16, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 16, 2019

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 Primary

Addresses

Primary practice location

8200 Georgia St
Merrillville, IN 46410-6227

Mailing address

8200 Georgia St
Merrillville, IN 46410-6227

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL
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
I20250402003214 IL Practitioner - Clinical Social Worker 5890218523 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Anxiety and Stress Center PCGroup PAC ID 9032299474, 7 clinicians

Practice addresses (Care Compare)

18161 Morris Ave
Suite 102
Homewood, IL 60430-2140
Phone (708) 349-5433

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Innovations in Learning, PC Mental Health CurrentSince Aug 18, 2019 Accepting new patients
Anxiety and Stress Center, P.C. CurrentSince Mar 31, 2025 Accepting new patients

Locations

18161 Morris Ave
Ste 102
Homewood, IL 60430
Phone (708) 349-5433

15030 S Ravinia Ave
Ste 32
Orland Park, IL 60462
Phone (708) 349-5433

8200 Georgia St
Merrillville, IN 46410
Phone (219) 791-1400

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": "1565913600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1565913600000",
    "number": "1306492103",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8200 GEORGIA ST",
            "city": "MERRILLVILLE",
            "state": "IN",
            "postal_code": "464106227"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8200 GEORGIA ST",
            "city": "MERRILLVILLE",
            "state": "IN",
            "postal_code": "464106227",
            "telephone_number": "219-791-1400"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MABRY",
        "first_name": "CHARISMA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-08-16",
        "last_updated": "2019-08-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Merrillville, IN

Sources for this page

Verify at the official NPI Registry.