Active NPI
Alyssa Broshar
- Mental Health Counselor
- West Lafayette, IN
National Provider Identifier
1588056949
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Mental Health Counselor
- Practice address
- 2167 Tecumseh Park LN
West Lafayette, IN 47906-2118 - Phone
- (219) 742-4972
- NPI assigned
- Feb 23, 2015
- Last updated
- Nov 18, 2022
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | NU | Primary |
Addresses
Primary practice location
2167 Tecumseh Park LN
West Lafayette, IN 47906-2118
Mailing address
2167 Tecumseh Park LN
West Lafayette, IN 47906-2118
Phone (219) 742-4972
Other practice location 1
8200 Georgia St
Merrillville, IN 46410-6227
Phone (219) 791-1400
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
Enrollment records 1
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Sondermind Provider Network LLC | Current | Accepting new patients | |
| Innovations in Learning, PC | Mental Health | Past | Accepting new patients |
Locations
333 N Alabama St
Ste 350
Indianapolis, IN 46204
Phone (317) 983-0002
Organizations & group practices 2
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.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1424649600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1668729600000",
"number": "1588056949",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2167 TECUMSEH PARK LN",
"city": "WEST LAFAYETTE",
"state": "IN",
"postal_code": "479062118",
"telephone_number": "219-742-4972"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2167 TECUMSEH PARK LN",
"city": "WEST LAFAYETTE",
"state": "IN",
"postal_code": "479062118",
"telephone_number": "219-742-4972"
}
],
"practiceLocations": [
{
"address_1": "8200 Georgia St",
"address_purpose": "LOCATION",
"city": "Merrillville",
"state": "IN",
"postal_code": "464106227",
"country_code": "US",
"telephone_number": "219-791-1400",
"fax_number": "219-791-1422",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "BROSHAR",
"first_name": "ALYSSA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2015-02-23",
"last_updated": "2022-11-18",
"certification_date": "2022-11-18",
"status": "A"
},
"taxonomies": [
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": "NU",
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in West Lafayette, IN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 18, 2022; 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.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.