Active NPI
Connie Beth Fetsch, LCSW
- Mental Health Counselor
- Indianapolis, IN
National Provider Identifier
1316155146
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Mental Health Counselor
- License
- 34003428A
- Practice address
- 650 E Southport Rd
Suite C
Indianapolis, IN 46227-8592 - Phone
- (317) 996-2321
- NPI assigned
- May 17, 2007
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | 34003428A | IN | Primary |
Addresses
Primary practice location
650 E Southport Rd
Suite C
Indianapolis, IN 46227-8592
Mailing address
650 E Southport Rd
Suite C
Indianapolis, IN 46227-8592
Phone (317) 996-2321
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)
- Enrolled
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| St. Francis Hospital | 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.
-
- General Acute Care Hospital
- Indianapolis, IN
- NPI 1528243060
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1179360000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1316155146",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "650 E SOUTHPORT RD",
"address_2": "SUITE C",
"city": "INDIANAPOLIS",
"state": "IN",
"postal_code": "462278592",
"telephone_number": "317-996-2321"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "650 E SOUTHPORT RD",
"address_2": "SUITE C",
"city": "INDIANAPOLIS",
"state": "IN",
"postal_code": "462278592",
"telephone_number": "317-996-2321"
}
],
"practiceLocations": [],
"basic": {
"last_name": "FETSCH",
"first_name": "CONNIE",
"middle_name": "BETH",
"credential": "LCSW",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-05-17",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": "IN",
"license": "34003428A",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}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 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.