NPIMap

Organization Active NPI

Lakeview Wesleyan Church

Doing business as Life Center Counseling Service

  • Specialist
  • Marion, IN
National Provider Identifier
1568568947
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
Legal business name
LAKEVIEW WESLEYAN CHURCH
Doing business as
Life Center Counseling Service
Practice address
5230 S Western Ave
Marion, IN 46953-5778
Phone
(765) 674-2208
Fax
(765) 674-3273
NPI assigned
Sep 15, 2006
Last updated
Jul 21, 2022By the provider in NPPES
Organization subpart
Yes
Parent organization
LAKEVIEW WESLEYAN CHURCHAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

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

Authorized official

Name
April D Leach
Title
Official Delegate
Phone
(765) 674-2208

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X IN Primary

Addresses

Primary practice location

5230 S Western Ave
Marion, IN 46953-5778

Mailing address

5230 S Western Ave
Marion, IN 46953-5778
Phone (765) 674-2208

Other identifiers 7

IdentifierTypeStateIssuer
467557OtherINAETNA
351044OtherINVALUE OPTIONS
100124010BMedicaidIN
249441000OtherINMAGELLAN
000000175674OtherINBLUE CROSS BLUE SHIELD
100124010AMedicaidIN
1044124OtherINCIGNA

Other names 1

  • Life Center Counseling Service Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040914000489 IN Part B Supplier - Clinic/Group Practice 5799752242 Receives reassigned benefits from 6 practitioners
Practice locations: Marion, IN

National Provider Directory

National Provider Directory
Part of
Life Center Counseling

Locations

118 N Jefferson St
Hartford City, IN 47348
Phone (765) 348-3946

120 N Jefferson St
Hartford City, IN 47348
Phone (765) 348-3946

2714 S Carey St
Marion, IN 46953

423 S Gallatin St
Marion, IN 46953
Phone (765) 674-2208

Practitioners & affiliated clinicians

Practitioners 13

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 13

NPI Registry JSON

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

{
    "created_epoch": "1158278400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1658361600000",
    "number": "1568568947",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5230 S WESTERN AVE",
            "city": "MARION",
            "state": "IN",
            "postal_code": "469535778",
            "telephone_number": "765-674-2208",
            "fax_number": "765-674-3273"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5230 S WESTERN AVE",
            "city": "MARION",
            "state": "IN",
            "postal_code": "469535778",
            "telephone_number": "765-674-2208",
            "fax_number": "765-674-3273"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LAKEVIEW WESLEYAN CHURCH",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "LAKEVIEW WESLEYAN CHURCH",
        "enumeration_date": "2006-09-15",
        "last_updated": "2022-07-21",
        "status": "A",
        "authorized_official_last_name": "LEACH",
        "authorized_official_first_name": "APRIL",
        "authorized_official_middle_name": "D",
        "authorized_official_title_or_position": "OFFICIAL DELEGATE",
        "authorized_official_telephone_number": "765-674-2208"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "IN",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "467557",
            "state": "IN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "VALUE OPTIONS",
            "identifier": "351044",
            "state": "IN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100124010B",
            "state": "IN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MAGELLAN",
            "identifier": "249441000",
            "state": "IN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "000000175674",
            "state": "IN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100124010A",
            "state": "IN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CIGNA",
            "identifier": "1044124",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Life Center Counseling Service",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Marion, IN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.