Kerry Minnis, LCSW, LMFT, LCAC

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

34000534A Issued in IN

Practice address

610 E Southport Rd
Suite 100
Indianapolis, IN 46227-8581

Phone

(317) 783-8477

NPI assigned

Mar 11, 2007

Sex

Male

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

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.

• St. Francis Hospital and Health Centers

  • Psychiatry Physician
  • Indianapolis, IN
  • NPI 1306876446

  Clinical

  NPD (past)

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

{
    "created_epoch": "1173571200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1376870400000",
    "number": "1487786935",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10155 E THOMPSON RD",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462399350",
            "telephone_number": "317-862-1821"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "610 E SOUTHPORT RD",
            "address_2": "SUITE 100",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462278581",
            "telephone_number": "317-783-8477"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MINNIS",
        "first_name": "KERRY",
        "name_prefix": "Mr.",
        "credential": "LCSW, LMFT, LCAC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-03-11",
        "last_updated": "2013-08-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "IN",
            "license": "34000534A",
            "primary": true
        },
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "IN",
            "license": "35000242A",
            "primary": false
        },
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "IN",
            "license": "87000437A",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jason Adam Minnich II
• Kevin Minnick, LMHC
• Rease Joan Minniear, RN
• Hal J Minnigan, MD
• Karen Minnis, LMFTA
• Antionette S. Minor, PSA
• Cheveria Minor, MSW
• James R Minor, MD
• Joy Elisha Minor, MA
• Lisa Rivka Minor, PH.D, HSPP, BCBA-D

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 19, 2013; 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.