Harborside Counseling and Mediation LLC

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

Legal business name

HARBORSIDE COUNSELING AND MEDIATION LLC

Practice address

1400 E Angela Blvd
South Bend, IN 46617-1364

Phone

(574) 212-2494

NPI assigned

Apr 22, 2022

Last updated

Apr 22, 2022By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Brianne Marie Milligan, MA, CTP

Title

Ceo

Phone

(574) 274-7358

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1650585600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1650585600000",
    "number": "1598409955",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1400 E ANGELA BLVD",
            "city": "SOUTH BEND",
            "state": "IN",
            "postal_code": "466171364",
            "telephone_number": "574-212-2494"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1400 E ANGELA BLVD",
            "city": "SOUTH BEND",
            "state": "IN",
            "postal_code": "466171364",
            "telephone_number": "574-212-2494"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HARBORSIDE COUNSELING AND MEDIATION LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-04-22",
        "last_updated": "2022-04-22",
        "certification_date": "2022-04-22",
        "status": "A",
        "authorized_official_last_name": "MILLIGAN",
        "authorized_official_first_name": "BRIANNE",
        "authorized_official_middle_name": "MARIE",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "574-274-7358",
        "authorized_official_credential": "MA, CTP"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Mental Health Counselor in South Bend, IN
• Providers in South Bend, 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 Apr 22, 2022; 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.