Individual provider Active NPI

Anthony J Garascia, M.S.

  • Mental Health Counselor
  • South Bend, IN
National Provider Identifier
1619948643
Registry record updated Oct 6, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
34002363A Issued in IN
Practice address
300 S Saint Louis Blvd
Ste 200
South Bend, IN 46617-3044
Phone
(574) 335-8250
Fax
(574) 335-0788
NPI assigned
Jan 28, 2006
Last updated
Oct 6, 2021By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 6, 2021

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 34002363A IN Primary

Addresses

Primary practice location

300 S Saint Louis Blvd
Ste 200
South Bend, IN 46617-3044

Mailing address

300 S Saint Louis Blvd
Ste 200
South Bend, IN 46617-3044
Phone (574) 335-8707

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
I20130131000471 IN Practitioner - Clinical Social Worker 6305090267 Practice locations: South Bend, IN

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Science

NPI Registry JSON

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

{
    "created_epoch": "1138406400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1633478400000",
    "number": "1619948643",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "300 S SAINT LOUIS BLVD",
            "address_2": "STE 200",
            "city": "SOUTH BEND",
            "state": "IN",
            "postal_code": "466173044",
            "telephone_number": "574-335-8707"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "300 S SAINT LOUIS BLVD",
            "address_2": "STE 200",
            "city": "SOUTH BEND",
            "state": "IN",
            "postal_code": "466173044",
            "telephone_number": "574-335-8250",
            "fax_number": "574-335-0788"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GARASCIA",
        "first_name": "ANTHONY",
        "middle_name": "J",
        "name_prefix": "Mr.",
        "credential": "M.S.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-01-28",
        "last_updated": "2021-10-06",
        "certification_date": "2021-10-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "IN",
            "license": "34002363A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in South Bend, IN

Sources for this page

Verify at the official NPI Registry.