Individual provider Active NPI

Amy Lynn Staraitis

  • Mental Health Counselor
  • Corydon, IN
National Provider Identifier
1457133928
Registry record updated Feb 4, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
39005845A Issued in IN
Practice address
535 Country Club Rd SE
Corydon, IN 47112-1705
Phone
(812) 738-2114
NPI assigned
Oct 18, 2023
Last updated
Feb 4, 2026By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 4, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health CounselorGroup: 193400000X SINGLE SPECIALTY GROUP 101YM0800X 39005845A IN Primary

Addresses

Primary practice location

535 Country Club Rd SE
Corydon, IN 47112-1705

Mailing address

7400 Bruner LN SW
Central, IN 47110-7834
Phone (502) 345-9916

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IN
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 1

Enrollment IDStateProvider typePAC IDDetails
I20260218002230 IN Practitioner - Mental Health Counselor 8820578750 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Lifespring, IncGroup PAC ID 5294624508, 65 clinicians

Practice addresses (Care Compare)

535 Country Club Serd
Corydon, IN 47112-1705
Phone (812) 738-2114

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
39005845AINMDMental Health Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Lifespring, Inc CurrentSince Jan 21, 2026 Accepting new patients
Lifespring, Inc Single Specialty CurrentSince Jan 21, 2026 Accepting new patients

Locations

535 Country Club Rd SE
Corydon, IN 47112
Phone (812) 265-4513

1036 Sharon Dr
Jeffersonvlle, IN 47130
Phone (812) 258-9281

460 Spring St
Jeffersonvlle, IN 47130
Phone (812) 280-3583

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1697587200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1770163200000",
    "number": "1457133928",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7400 BRUNER LN SW",
            "city": "CENTRAL",
            "state": "IN",
            "postal_code": "471107834",
            "telephone_number": "502-345-9916"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "535 COUNTRY CLUB RD SE",
            "city": "CORYDON",
            "state": "IN",
            "postal_code": "471121705",
            "telephone_number": "812-738-2114"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STARAITIS",
        "first_name": "AMY",
        "middle_name": "LYNN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2023-10-18",
        "last_updated": "2026-02-04",
        "certification_date": "2026-02-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Counselor, Mental Health",
            "state": "IN",
            "license": "39005845A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Corydon, IN

Sources for this page

Verify at the official NPI Registry.