Individual provider Active NPI

Danielle Bastian, LMHC

  • Mental Health Counselor
  • Lafayette, IN
National Provider Identifier
1699366153
Registry record updated Jan 12, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
88001339A Issued in IN
Practice address
615 N 18TH St Ste 101
Lafayette, IN 47904-3413
Phone
(765) 423-5361
Fax
(765) 447-8411
NPI assigned
Jan 28, 2021
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 12, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X 88001339A IN Primary
Mental Health CounselorGroup: 193400000X SINGLE SPECIALTY GROUP 101YM0800X 99102625A IN

Addresses

Primary practice location

615 N 18TH St Ste 101
Lafayette, IN 47904-3413

Mailing address

615 N 18TH St Ste 101
Lafayette, IN 47904-3413
Phone (765) 423-5361

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

State licenses

LicenseStateTypeSpecialty
88001339AINMDMental Health Counselor
99102625AINMDMental Health Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Willowstone Family Services Mental Health CurrentSince Jan 31, 2021 Accepting new patients
Enlightened Mental Health, LLC Single Specialty Past Accepting new patients

Locations

615 N 18th St
Ste 101
Lafayette, IN 47904
Phone (765) 423-5361

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": "1611792000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1641945600000",
    "number": "1699366153",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "615 N 18TH ST STE 101",
            "city": "LAFAYETTE",
            "state": "IN",
            "postal_code": "479043413",
            "telephone_number": "765-423-5361",
            "fax_number": "765-447-8411"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "615 N 18TH ST STE 101",
            "city": "LAFAYETTE",
            "state": "IN",
            "postal_code": "479043413",
            "telephone_number": "765-423-5361",
            "fax_number": "765-447-8411"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BASTIAN",
        "first_name": "DANIELLE",
        "credential": "LMHC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-01-28",
        "last_updated": "2022-01-12",
        "certification_date": "2022-01-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "IN",
            "license": "88001339A",
            "primary": true
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Counselor, Mental Health",
            "state": "IN",
            "license": "99102625A",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lafayette, IN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 12, 2022; 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.