Chantal M Hacker

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

39005033A Issued in IN

Practice address

5555 N Tacoma Ave
Indianapolis, IN 46220-3512

Phone

(317) 257-7434

NPI assigned

Jul 12, 2021

Last updated

Aug 12, 2024By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other names 1

• Chantal Derisse Professional name

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

Specialty

Mental Health Counselor

Education

Other, 2021

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Sanders and Associates LLCGroup PAC ID 6002982402, 2 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

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.

• Sanders and Associates. LLC

  • Clinical Social Worker
  • Indianapolis, IN
  • NPI 1225295447
  Medicare reassignment Care Compare group NPD
• Mental Health Specialty Group PA

  dba Rula Health

  • Mental Health Counselor
  • Durham, NC
  • NPI 1801472634

  IN

  Medicare reassignment NPD
• Stress Reduction Christian Ministry LLC

  • Community/Behavioral Health Agency
  • Indianapolis, IN
  • NPI 1225849292
  NPD Authorized official

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

{
    "created_epoch": "1626048000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1723420800000",
    "number": "1548832454",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1494 BYRON ST",
            "city": "GREENFIELD",
            "state": "IN",
            "postal_code": "461406930",
            "telephone_number": "317-453-0452"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5555 N TACOMA AVE",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462203512",
            "telephone_number": "317-257-7434"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1494 Byron St",
            "address_purpose": "LOCATION",
            "city": "Greenfield",
            "state": "IN",
            "postal_code": "461406930",
            "country_code": "US",
            "telephone_number": "317-453-0452",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HACKER",
        "first_name": "CHANTAL",
        "middle_name": "M",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-07-12",
        "last_updated": "2024-08-12",
        "certification_date": "2024-08-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "IN",
            "license": "39005033A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "CHANTAL",
            "last_name": "DERISSE",
            "credential": "MS. HACKER",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

• Philip Habing, PHARMD
• Emily Hable, OD
• Marcy Haboush, LCSW
• Habr LLC
• Cynthia Kelly Hacherl
• Briann Hackman
• Brooke Noelle Hackman, CCC-SLP
• Daniel Thomas Hackman, M.D.
• Terrianna Hackney
• Ivan Hadad, M.D.

• Mental Health Counselor in Indianapolis, IN
• Providers in Indianapolis, 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 Aug 12, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.