South Bend Wellness Center LLC

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

Legal business name

SOUTH BEND WELLNESS CENTER LLC

Practice address

52081 Glen Arbor CT
Granger, IN 46530-7813

Phone

(574) 329-1316

NPI assigned

Jul 25, 2023

Organization subpart

No

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

Authorized official

Name

Sarah Von Der Mehden, LCSW

Title

Owner

Phone

(574) 329-1316

Specialties & licenses 1

Addresses

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Alicia Weyer

  • Social Worker
  • Mishawaka, IN
  • NPI 1285444067
  NPD

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

{
    "created_epoch": "1690243200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1690243200000",
    "number": "1467133207",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "52081 GLEN ARBOR CT",
            "city": "GRANGER",
            "state": "IN",
            "postal_code": "465307813"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "52081 GLEN ARBOR CT",
            "city": "GRANGER",
            "state": "IN",
            "postal_code": "465307813",
            "telephone_number": "574-329-1316"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTH BEND WELLNESS CENTER LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-07-25",
        "last_updated": "2023-07-25",
        "certification_date": "2023-07-25",
        "status": "A",
        "authorized_official_last_name": "VON DER MEHDEN",
        "authorized_official_first_name": "SARAH",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "574-329-1316",
        "authorized_official_credential": "LCSW"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Ben N Smith IV, PHD
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• Mental Health Counselor in Granger, IN
• Providers in Granger, IN by specialty
• Mental Health Counselor in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 25, 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.