Individual provider Active NPI

Thomas D Phelps, LMHC

  • Mental Health Counselor
  • Bloomington, IN
National Provider Identifier
1629530464
Registry record updated Apr 3, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
39003488A Issued in IN
Practice address
645 S Rogers St
Bloomington, IN 47403-2353
Phone
(812) 339-1691
NPI assigned
Apr 2, 2019
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 3, 2024

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 39003488A IN Primary

Addresses

Primary practice location

645 S Rogers St
Bloomington, IN 47403-2353

Mailing address

645 S Rogers St
Bloomington, IN 47403-2353
Phone (812) 339-1691

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
I20240425003121 IN Practitioner - Mental Health Counselor 8729428669 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Centerstone of Indiana, Inc. Current Accepting new patients
Centerstone of Indiana, Inc. CurrentSince Mar 23, 2024 Accepting new patients

Locations

1315 Hillcrest Rd
Bedford, IN 47421
Phone (812) 279-3591

645 S Rogers St
Bloomington, IN 47403
Phone (812) 339-1691

720 N Marr Rd
Columbus, IN 47201
Phone (812) 314-3400

952 S Main St
Martinsville, IN 46151
Phone (765) 342-3316

831 Dillon Dr
Richmond, IN 47374
Phone (765) 983-8000

35 Bob Babbs Dr
Spencer, IN 47460
Phone (812) 652-1700

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1554163200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1712102400000",
    "number": "1629530464",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "645 S ROGERS ST",
            "city": "BLOOMINGTON",
            "state": "IN",
            "postal_code": "474032353",
            "telephone_number": "812-339-1691"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "645 S ROGERS ST",
            "city": "BLOOMINGTON",
            "state": "IN",
            "postal_code": "474032353",
            "telephone_number": "812-339-1691"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PHELPS",
        "first_name": "THOMAS",
        "middle_name": "D",
        "credential": "LMHC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-04-02",
        "last_updated": "2024-04-03",
        "certification_date": "2024-04-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "IN",
            "license": "39003488A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bloomington, IN

Sources for this page

Verify at the official NPI Registry.