Sibis Counseling Center LLC

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

39000758 A Issued in IN

Legal business name

SIBIS COUNSELING CENTER LLC

Practice address

3195 Broadway Lowr Level
Gary, IN 46409-1006

Phone

(219) 884-1655

Fax

(219) 884-1651

NPI assigned

Jan 9, 2012

Organization subpart

No

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

Authorized official

Name

Dr. Benjamin Leon, PH.D, ED.D, LMHC,

Title

President /Ceo

Phone

(219) 884-1655

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Sibis Enterprises Inc. Former legal business name

Locations

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

{
    "created_epoch": "1326067200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1326067200000",
    "number": "1548530439",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3195 BROADWAY LOWR LEVEL",
            "city": "GARY",
            "state": "IN",
            "postal_code": "464091006",
            "telephone_number": "219-884-1655",
            "fax_number": "219-884-1651"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3195 BROADWAY LOWR LEVEL",
            "city": "GARY",
            "state": "IN",
            "postal_code": "464091006",
            "telephone_number": "219-884-1655",
            "fax_number": "219-884-1651"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SIBIS COUNSELING CENTER LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-01-09",
        "last_updated": "2012-01-09",
        "status": "A",
        "authorized_official_last_name": "LEON",
        "authorized_official_first_name": "BENJAMIN",
        "authorized_official_title_or_position": "PRESIDENT /CEO",
        "authorized_official_telephone_number": "219-884-1655",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PH.D, ED.D, LMHC,"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Mental Health",
            "state": "IN",
            "license": "39000758 A",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200940750",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Sibis Enterprises Inc.",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

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• Mental Health Counselor in Gary, IN
• Providers in Gary, 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 Jan 9, 2012; 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.