Individual provider Active NPI

Athena Soleim, LCSW

  • Clinical Social Worker
  • Valparaiso, IN
National Provider Identifier
1689217697
Registry record updated Jul 1, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
Practice address
2254 Saint Joseph LN
Valparaiso, IN 46385-5449
Phone
(219) 801-6453
NPI assigned
Oct 22, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 1, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X Primary
Clinical Social Worker 1041C0700X 34007296A IN

Addresses

Primary practice location

2254 Saint Joseph LN
Valparaiso, IN 46385-5449

Mailing address

467 N 211 E
Valparaiso, IN 46383-9147

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address Admin@onlineindianatherapy.com Direct

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
I20240427001879 IN Practitioner - Clinical Social Worker 6709226558 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Mental Health Specialty Group PAGroup PAC ID 8921466228, 726 clinicians

Practice addresses (Care Compare)

Indianapolis, IN 46204
Phone (323) 205-7088

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
34007296AINMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Grow Healthcare Group PA Clinical CurrentSince Apr 3, 2024 Accepting new patients
Talkspace Provider Network PA CurrentSince Feb 6, 2025 Accepting new patients
Mental Health Specialty Group PA CurrentSince May 1, 2025 Accepting new patients
Restoring Hope LLC CurrentSince Oct 27, 2019 Accepting new patients

Locations

66 W Flagler St
Ste 900
Miami, FL 33130
Phone (786) 244-7711

9465 Counselors Row
Ste 200
Indianapolis, IN 46240
Phone (463) 220-4646

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

2578 Broadway
Ste 607
New York, NY 10025
Phone (304) 308-3735

Interoperability endpoints

  • Direct secure messaging: admin@onlineindianatherapy.com

Organizations & group practices 4

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": "1571702400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1719792000000",
    "number": "1689217697",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "467 N 211 E",
            "city": "VALPARAISO",
            "state": "IN",
            "postal_code": "463839147"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2254 SAINT JOSEPH LN",
            "city": "VALPARAISO",
            "state": "IN",
            "postal_code": "463855449",
            "telephone_number": "219-801-6453"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SOLEIM",
        "first_name": "ATHENA",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-10-22",
        "last_updated": "2024-07-01",
        "certification_date": "2024-07-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "IN",
            "license": "34007296A",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "Admin@onlineindianatherapy.com",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "None",
            "address_1": "2254 Saint Joseph Ln",
            "city": "Valparaiso",
            "state": "IN",
            "country_code": "US",
            "postal_code": "463855449",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Valparaiso, IN

Sources for this page

Verify at the official NPI Registry.