Individual provider Active NPI

Susan Blake Krider, LMHCA

  • Mental Health Counselor
  • Columbus, IN
National Provider Identifier
1578196986
Registry record updated Feb 14, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
Practice address
927 4TH St
Columbus, IN 47201-6824
Phone
(812) 372-1571
NPI assigned
Feb 14, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 14, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X Primary

Addresses

Primary practice location

927 4TH St
Columbus, IN 47201-6824

Mailing address

719 5TH St
Columbus, IN 47201-6306
Phone (812) 372-1571

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20240930001983 IN Practitioner - Mental Health Counselor 3577094739 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Saint Peter'S Lutheran ChurchGroup PAC ID 8224579818, 6 clinicians

Practice addresses (Care Compare)

927 4TH St
Columbus, IN 47201-6824
Phone (812) 799-3530

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Saint Peter'S Lutheran Church CurrentSince Aug 18, 2024 Accepting new patients

Locations

927 4th St
Columbus, IN 47201
Phone (812) 372-1571

719 5th St
Columbus, IN 47201
Phone (812) 581-7703

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1581638400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1581638400000",
    "number": "1578196986",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "719 5TH ST",
            "city": "COLUMBUS",
            "state": "IN",
            "postal_code": "472016306",
            "telephone_number": "812-372-1571"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "927 4TH ST",
            "city": "COLUMBUS",
            "state": "IN",
            "postal_code": "472016824",
            "telephone_number": "812-372-1571"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KRIDER",
        "first_name": "SUSAN",
        "middle_name": "BLAKE",
        "name_prefix": "Ms.",
        "credential": "LMHCA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-02-14",
        "last_updated": "2020-02-14",
        "certification_date": "2020-02-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Columbus, IN

Sources for this page

Verify at the official NPI Registry.