NPIMap

Organization Active NPI

LDS Family Services

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Carmel, IN
National Provider Identifier
1407072762
Registry record updated Sep 14, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health Clinic/Center (Including Community Mental Health Center)Taxonomy code 261QM0801X
License
169096933 Issued in IN
Legal business name
LDS FAMILY SERVICES
Doing business as
LDS Family Services Indiana Agency
Practice address
550 Congressional Blvd
Suite 125
Carmel, IN 46032-5609
Phone
(317) 872-1749
Fax
(317) 872-1756
NPI assigned
Apr 17, 2007
Organization subpart
Yes
Parent organization
LDS FAMILY SERVICESAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Sep 14, 2009

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

Authorized official

Name
Mr. Matthew J Wilson, LCSW
Title
Counseling Supervisor
Phone
(317) 522-0224

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Clinic/Center (Including Community Mental Health Center) 261QM0801X 169096933 IN Primary

Addresses

Primary practice location

550 Congressional Blvd
Suite 125
Carmel, IN 46032-5609

Mailing address

550 Congressional Blvd
Suite 125
Carmel, IN 46032-5609
Phone (317) 872-1749

Other names 1

  • LDS Family Services Indiana Agency Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Robert D Smith PHD46 organizations share this tax ID, including this one
Part of
Robert D Smith PHD

Other organizations with this tax ID 45

Organizations that report the same tax identification number in the National Provider Directory.

View all 45

Locations

550 Congressional Blvd
Ste 125
Carmel, IN 46032
Phone (317) 872-1749

NPI Registry JSON

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

{
    "created_epoch": "1176768000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1252886400000",
    "number": "1407072762",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "550 CONGRESSIONAL BLVD",
            "address_2": "SUITE 125",
            "city": "CARMEL",
            "state": "IN",
            "postal_code": "460325609",
            "telephone_number": "317-872-1749",
            "fax_number": "317-872-1756"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "550 CONGRESSIONAL BLVD",
            "address_2": "SUITE 125",
            "city": "CARMEL",
            "state": "IN",
            "postal_code": "460325609",
            "telephone_number": "317-872-1749",
            "fax_number": "317-872-1756"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LDS FAMILY SERVICES",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "LDS FAMILY SERVICES",
        "enumeration_date": "2007-04-17",
        "last_updated": "2009-09-14",
        "status": "A",
        "authorized_official_last_name": "WILSON",
        "authorized_official_first_name": "MATTHEW",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "COUNSELING SUPERVISOR",
        "authorized_official_telephone_number": "317-522-0224",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "LCSW"
    },
    "taxonomies": [
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": "IN",
            "license": "169096933",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "LDS Family Services Indiana Agency",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Carmel, IN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 14, 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.

Verify at the official NPI Registry.