Katherine Revah Guy, L.M.H.C.,L.A.C.,M.S.

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

39001988A Issued in IN

Practice address

615 Fulmer Rd
Mishawaka, IN 46544-6911

Phone

(574) 274-1162

Fax

(888) 826-3722

NPI assigned

May 5, 2011

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Science

State licenses

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

{
    "created_epoch": "1304553600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1331683200000",
    "number": "1669764965",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5725 S BRIDGETON LN",
            "city": "SOUTH BEND",
            "state": "IN",
            "postal_code": "466146318"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "615 FULMER RD",
            "city": "MISHAWAKA",
            "state": "IN",
            "postal_code": "465446911",
            "telephone_number": "574-274-1162",
            "fax_number": "888-826-3722"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GUY",
        "first_name": "KATHERINE",
        "middle_name": "REVAH",
        "name_prefix": "Mrs.",
        "credential": "L.M.H.C.,L.A.C.,M.S.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2011-05-05",
        "last_updated": "2012-03-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "IN",
            "license": "39001988A",
            "primary": true
        },
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "IN",
            "license": "86000180A",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Mental Health Counselor in Mishawaka, IN
• Providers in Mishawaka, IN by specialty
• Mental Health Counselor in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 14, 2012; 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.