Organization Active NPI

Life Paths Counseling, LLC

  • Clinical Social Worker
  • Bloomington, IN
National Provider Identifier
1366883274
Registry record updated Dec 22, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
34005660A Issued in IN
Legal business name
LIFE PATHS COUNSELING, LLC
Practice address
101 W Kirkwood Ave Ste 222
Bloomington, IN 47404-6133
Phone
(812) 361-1234
NPI assigned
Jul 9, 2013
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 22, 2014

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

Authorized official

Name
Heather M Hudson, LCSW
Title
Owner
Phone
(812) 361-1234

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social WorkerGroup: 193400000X SINGLE SPECIALTY GROUP 1041C0700X 34005660A IN Primary

Addresses

Primary practice location

101 W Kirkwood Ave Ste 222
Bloomington, IN 47404-6133

Mailing address

101 W Kirkwood Ave Ste 222
Bloomington, IN 47404-6133
Phone (812) 361-1234

Other identifiers 1

IdentifierTypeStateIssuer
IN1464OtherMEDICARE PTAN

National Provider Directory

National Provider Directory

Locations

101 W Kirkwood Ave
Ste 222
Bloomington, IN 47404
Phone (812) 219-1314

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1373328000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1419206400000",
    "number": "1366883274",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "101 W KIRKWOOD AVE STE 222",
            "city": "BLOOMINGTON",
            "state": "IN",
            "postal_code": "474046133",
            "telephone_number": "812-361-1234",
            "fax_number": "812-676-9351"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "101 W KIRKWOOD AVE STE 222",
            "city": "BLOOMINGTON",
            "state": "IN",
            "postal_code": "474046133",
            "telephone_number": "812-361-1234"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LIFE PATHS COUNSELING, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-07-09",
        "last_updated": "2014-12-22",
        "status": "A",
        "authorized_official_last_name": "HUDSON",
        "authorized_official_first_name": "HEATHER",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "812-361-1234",
        "authorized_official_credential": "LCSW"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Social Worker, Clinical",
            "state": "IN",
            "license": "34005660A",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PTAN",
            "identifier": "IN1464",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Bloomington, IN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 22, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.