Individual provider Active NPI

Autumn M Vendramin, LMHC, BCBA

  • Mental Health Counselor
  • Chesterton, IN
National Provider Identifier
1609042498
Registry record updated Jun 5, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
39001748A Issued in IN
Practice address
442 N Calumet Rd
Ste 100
Chesterton, IN 46304-2489
Phone
(219) 359-3272
Fax
(219) 359-3089
NPI assigned
May 1, 2008
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 5, 2014

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X 39001748A IN Primary
Behavior Analyst 103K00000X

Addresses

Primary practice location

442 N Calumet Rd
Ste 100
Chesterton, IN 46304-2489

Mailing address

4989 W 450 N
La Porte, IN 46350-7403
Phone (219) 508-1594

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
39001748AINMDMental Health Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Life Strategies, LLC Mental Health Past Accepting new patients

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": "1209600000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1401926400000",
    "number": "1609042498",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4989 W 450 N",
            "city": "LA PORTE",
            "state": "IN",
            "postal_code": "463507403",
            "telephone_number": "219-508-1594",
            "fax_number": "219-359-3089"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "442 N CALUMET RD",
            "address_2": "STE 100",
            "city": "CHESTERTON",
            "state": "IN",
            "postal_code": "463042489",
            "telephone_number": "219-359-3272",
            "fax_number": "219-359-3089"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VENDRAMIN",
        "first_name": "AUTUMN",
        "middle_name": "M",
        "credential": "LMHC, BCBA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-05-01",
        "last_updated": "2014-06-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "IN",
            "license": "39001748A",
            "primary": true
        },
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chesterton, IN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 5, 2014; 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.