Individual provider Active NPI

Thomas Adrian Dehorn, LMHC

  • Mental Health Counselor
  • Michigan City, IN
National Provider Identifier
1700111457
Registry record updated Oct 14, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
39000127A Issued in IN
Practice address
450 Saint John Rd
Suite 501
Michigan City, IN 46360-7354
Phone
(219) 873-9828
Fax
(219) 873-2388
NPI assigned
Oct 14, 2009
Last updated
Oct 14, 2009By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 14, 2009

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 39000127A IN Primary

Addresses

Primary practice location

450 Saint John Rd
Suite 501
Michigan City, IN 46360-7354

Mailing address

450 Saint John Rd
Suite 501
Michigan City, IN 46360-7354
Phone (219) 873-9828

Other identifiers 1

IdentifierTypeStateIssuer
100163580AMedicaidIN

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
39000127AINMDMental Health Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Laporte County Comprehensive Mental Health Council Past Accepting new patients

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1255478400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1255478400000",
    "number": "1700111457",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "450 SAINT JOHN RD",
            "address_2": "SUITE 501",
            "city": "MICHIGAN CITY",
            "state": "IN",
            "postal_code": "463607354",
            "telephone_number": "219-873-9828",
            "fax_number": "219-873-2388"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "450 SAINT JOHN RD",
            "address_2": "SUITE 501",
            "city": "MICHIGAN CITY",
            "state": "IN",
            "postal_code": "463607354",
            "telephone_number": "219-873-9828",
            "fax_number": "219-873-2388"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DEHORN",
        "first_name": "THOMAS",
        "middle_name": "ADRIAN",
        "credential": "LMHC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2009-10-14",
        "last_updated": "2009-10-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "IN",
            "license": "39000127A",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100163580A",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Michigan City, IN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 14, 2009; 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.