Individual provider Active NPI

Jonnarda Tolbert

  • Mental Health Counselor
  • Merrillville, IN
National Provider Identifier
1407359805
Registry record updated Jun 10, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
39003879A Issued in IN
Practice address
8670 Broadway B
Suite E
Merrillville, IN 46410-7034
Phone
(219) 781-8791
NPI assigned
Mar 12, 2018
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 10, 2024

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Counselor 101Y00000X 88000570A IN
Mental Health Counselor 101YM0800X 88000570A IN
Mental Health Counselor 101YM0800X 39003879A IN Primary

Addresses

Primary practice location

8670 Broadway B
Suite E
Merrillville, IN 46410-7034

Mailing address

6555 Monda Avenue
Portage, IN 46368-4692
Phone (219) 781-8791

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IN, OH, IL3 enrollments
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 3

Enrollment IDStateProvider typePAC IDDetails
I20240619000067 IN Practitioner - Mental Health Counselor 9537602529 Reassigns benefits to 1 organization
I20260420003107 OH Practitioner - Mental Health Counselor 9537602529 Reassigns benefits to 1 organization
I20260421003081 IL Practitioner - Mental Health Counselor 9537602529 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 2010
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

66 E Flagler St
Miami, FL 33130-1807

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
88000570AINMDCounselor
39003879AINMDMental Health Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Lift Counseling Services LLC Mental Health CurrentSince Feb 2, 2018 Accepting new patients

Locations

8670 Broadway
Ste Eb
Merrillville, IN 46410
Phone (219) 781-8791

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": "1520812800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1717977600000",
    "number": "1407359805",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6555 MONDA AVENUE",
            "city": "PORTAGE",
            "state": "IN",
            "postal_code": "463684692",
            "telephone_number": "219-781-8791"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8670 BROADWAY B",
            "address_2": "SUITE E",
            "city": "MERRILLVILLE",
            "state": "IN",
            "postal_code": "464107034",
            "telephone_number": "219-781-8791"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TOLBERT",
        "first_name": "JONNARDA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-03-12",
        "last_updated": "2024-06-10",
        "certification_date": "2024-06-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": "IN",
            "license": "88000570A",
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "IN",
            "license": "88000570A",
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "IN",
            "license": "39003879A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Merrillville, IN

Sources for this page

Verify at the official NPI Registry.