Individual provider Active NPI

Lisa Mae Wedow, LMHC

  • Mental Health Counselor
  • Chesterton, IN
National Provider Identifier
1679915193
Registry record updated May 5, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
39002240A Issued in IN
Practice address
442 N Calumet Rd
Suite 100
Chesterton, IN 46304-2489
Phone
(219) 359-3272
NPI assigned
Jul 25, 2013
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 5, 2023

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 39002240A IN Primary

Addresses

Primary practice location

442 N Calumet Rd
Suite 100
Chesterton, IN 46304-2489

Mailing address

442 N Calumet Rd
Suite 100
Chesterton, IN 46304-2489
Phone (219) 359-3272

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
I20250128002289 IN Practitioner - Mental Health Counselor 6800325416 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Mental Health Specialty Group PA Mental Health CurrentSince Jan 23, 2025 Accepting new patients
Life Strategies, LLC Mental Health Past Accepting new patients

Locations

333 N Alabama St
Indianapolis, IN 46204
Phone (317) 395-3391

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": "1374710400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1683244800000",
    "number": "1679915193",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "442 N CALUMET RD",
            "address_2": "SUITE 100",
            "city": "CHESTERTON",
            "state": "IN",
            "postal_code": "463042489",
            "telephone_number": "219-359-3272"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "442 N CALUMET RD",
            "address_2": "SUITE 100",
            "city": "CHESTERTON",
            "state": "IN",
            "postal_code": "463042489",
            "telephone_number": "219-359-3272"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WEDOW",
        "first_name": "LISA",
        "middle_name": "MAE",
        "credential": "LMHC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-07-25",
        "last_updated": "2023-05-05",
        "certification_date": "2023-05-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "IN",
            "license": "39002240A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chesterton, IN

Sources for this page

Verify at the official NPI Registry.