Northside Mental Health

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

34006184A Issued in IN

Legal business name

NORTHSIDE MENTAL HEALTH

Practice address

6507 Ferguson St
Suite #102
Indianapolis, IN 46220-1294

Phone

(317) 819-8337

Fax

(317) 819-8332

NPI assigned

Dec 10, 2013

Organization subpart

No

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

Authorized official

Name

Kate Fisch, LCSW

Title

President

Phone

(317) 819-8337

Specialties & licenses 1

Addresses

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Stephanie Mowery, LCSW

  • Clinical Social Worker
  • Indianapolis, IN
  • NPI 1720460660
  NPD (past)

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

{
    "created_epoch": "1386633600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1386633600000",
    "number": "1689005118",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6507 FERGUSON ST",
            "address_2": "SUITE #102",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462201294",
            "telephone_number": "317-819-8337",
            "fax_number": "317-819-8332"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6507 FERGUSON ST",
            "address_2": "SUITE #102",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462201294",
            "telephone_number": "317-819-8337",
            "fax_number": "317-819-8332"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NORTHSIDE MENTAL HEALTH",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-12-10",
        "last_updated": "2013-12-10",
        "status": "A",
        "authorized_official_last_name": "FISCH",
        "authorized_official_first_name": "KATE",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "317-819-8337",
        "authorized_official_credential": "LCSW"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Social Worker, Clinical",
            "state": "IN",
            "license": "34006184A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Northside Cardiac Cath Lab Partnership
• Northside Dental Care
• Northside Endodontics, PC
• Northside Gastroenterology Endoscopy Center LLC
• Northside Gastroenterology, Inc., PC
• Northside Psychotherapy Services, LLC
• Northside Surgical Specialists, PC
• Northview Dental
• Northwest Medical Pain Control Services, PC
• Northwest Optical

• Clinical Social Worker in Indianapolis, IN
• Providers in Indianapolis, IN by specialty
• Clinical Social Worker in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 10, 2013; 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.