Timothy Lagro, MA

Individual provider Active NPI Mental Health Counselor · Lagrange, IN

NPI 1609124684 · NPPES record last updated Aug 22, 2012

Key facts

NPI
1609124684
Entity type
Individual (NPI type 1)
Primary specialty
Mental Health Counselor 101YM0800X
Practice address
836 N Detroit St
Lagrange, IN 46761-1112
Phone
(260) 499-3019
Fax
(260) 499-3022
NPI assigned
Aug 22, 2012
Sex
Male
Sole proprietor
No

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Eligible to order & refer
Part B services: No · DME: Yes · Home health: No · Power mobility devices: No · Hospice: No

National Provider Directory

Medicare enrollment (NPD)
Yes
Credentials
Master of Arts

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X Yes

Addresses

Primary practice location

836 N Detroit St
Lagrange, IN 46761-1112

Mailing address

850 N Harrison St
Warsaw, IN 46580-3163
Phone (574) 267-7169

Other providers in Lagrange, IN

All providers in Lagrange, IN · Mental Health Counselor in Indiana

Sources for this page

Verify at the official NPI Registry.