John Henry Proctor III, LSW

Primary specialty

Social WorkerTaxonomy code 104100000X

License

33011601A Issued in IN

Practice address

777 N Meridian St
Indianapolis, IN 46204-1420

Phone

(317) 650-4353

NPI assigned

Aug 2, 2023

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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.

• Irvington Counseling Collective Inc

  • Clinical Social Worker
  • Indianapolis, IN
  • NPI 1700412236
  NPD (past)
• Irvington Counseling, LLC

  dba Living on the Earth

  • Clinical Social Worker
  • Indianapolis, IN
  • NPI 1407617483
  NPD (past)

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

{
    "created_epoch": "1690934400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1690934400000",
    "number": "1437831286",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "777 N MERIDIAN ST",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462041420",
            "telephone_number": "317-650-4353"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "777 N MERIDIAN ST",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462041420",
            "telephone_number": "317-650-4353"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "203 Good Ave",
            "address_purpose": "LOCATION",
            "city": "Indianapolis",
            "state": "IN",
            "postal_code": "462197210",
            "country_code": "US",
            "telephone_number": "317-912-0096",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "7165 Clearvista Way",
            "address_purpose": "LOCATION",
            "city": "Indianapolis",
            "state": "IN",
            "postal_code": "462564621",
            "country_code": "US",
            "telephone_number": "317-621-5700 x1",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PROCTOR",
        "first_name": "JOHN",
        "middle_name": "HENRY",
        "name_prefix": "Mr.",
        "name_suffix": "III",
        "credential": "LSW",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2023-08-02",
        "last_updated": "2023-08-02",
        "certification_date": "2023-08-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "IN",
            "license": "33011601A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Philip Matthew Procento, PHD
• Lauren Nicole Procter, PA-C
• Alida Proctor, RBT
• Andrew Proctor, MSW,LSW
• Daren Proctor
• Paiden Proctor
• Stephanie Proctor
• Trinity Proctor, PSA
• Professional Assoc. PC
• Professional Associates PC

• Social Worker in Indianapolis, IN
• Providers in Indianapolis, IN by specialty
• Social Worker in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 2, 2023; 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.