Active NPI
Kelly Hendrickson
- Addiction (Substance Use Disorder) Counselor
- Merrillville, IN
National Provider Identifier
1649836685
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Addiction (Substance Use Disorder) Counselor
- Practice address
- 521 E 86TH Ave Ste H
Merrillville, IN 46410-6236 - Phone
- (219) 323-3311
- NPI assigned
- May 15, 2019
- Last updated
- May 22, 2019
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Addiction (Substance Use Disorder) Counselor | 101YA0400X | NU | Primary |
Addresses
Primary practice location
521 E 86TH Ave Ste H
Merrillville, IN 46410-6236
Mailing address
924 N Fairfield Ave # G
Chicago, IL 60622-4453
Phone (219) 512-3979
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
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Pillars of Wellness | Addiction (Substance Use Disorder) | 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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1557878400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1558483200000",
"number": "1649836685",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "924 N FAIRFIELD AVE # G",
"city": "CHICAGO",
"state": "IL",
"postal_code": "606224453",
"telephone_number": "219-512-3979"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "521 E 86TH AVE STE H",
"city": "MERRILLVILLE",
"state": "IN",
"postal_code": "464106236",
"telephone_number": "219-323-3311"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HENDRICKSON",
"first_name": "KELLY",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2019-05-15",
"last_updated": "2019-05-22",
"status": "A"
},
"taxonomies": [
{
"code": "101YA0400X",
"taxonomy_group": "",
"desc": "Counselor, Addiction (Substance Use Disorder)",
"state": "NU",
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Merrillville, IN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 22, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.