Active NPI
Idah Gudyanga
- Social Worker
- South Bend, IN
National Provider Identifier
1376783555
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Social Worker
- Practice address
- 108 N Main St
Suite 305
South Bend, IN 46601-1625 - Phone
- (574) 234-3515
- Fax
- (574) 234-3565
- NPI assigned
- Feb 27, 2009
- Last updated
- Mar 2, 2009
- 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Social Worker | 104100000X | Primary |
Addresses
Primary practice location
108 N Main St
Suite 305
South Bend, IN 46601-1625
Mailing address
108 N Main St
Suite 305
South Bend, IN 46601-1625
Phone (574) 234-3515
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 |
|---|---|---|---|
| Intrigue Counseling, Inc | 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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
- Clinical Social Worker
- South Bend, IN
- NPI 1841248754
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1235692800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1235952000000",
"number": "1376783555",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "108 N MAIN ST",
"address_2": "SUITE 305",
"city": "SOUTH BEND",
"state": "IN",
"postal_code": "466011625",
"telephone_number": "574-234-3515",
"fax_number": "574-234-3565"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "108 N MAIN ST",
"address_2": "SUITE 305",
"city": "SOUTH BEND",
"state": "IN",
"postal_code": "466011625",
"telephone_number": "574-234-3515",
"fax_number": "574-234-3565"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GUDYANGA",
"first_name": "IDAH",
"name_prefix": "Ms.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2009-02-27",
"last_updated": "2009-03-02",
"status": "A"
},
"taxonomies": [
{
"code": "104100000X",
"taxonomy_group": "",
"desc": "Social Worker",
"state": null,
"license": null,
"primary": true
}
],
"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 Mar 2, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.