Individual provider Active NPI

Joseph Nathan Laski, MA

  • Clinical Psychologist
  • South Bend, IN
National Provider Identifier
1710778899
Registry record updated Nov 24, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
20044010A Issued in IN
Practice address
3220 E Jefferson Blvd
South Bend, IN 46615-3028
Phone
(574) 222-2466
NPI assigned
May 16, 2025
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 24, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Psychologist 103T00000X 20044010A IN
Clinical Psychologist 103TC0700X 20044010A IN Primary

Addresses

Primary practice location

3220 E Jefferson Blvd
South Bend, IN 46615-3028

Mailing address

3220 E Jefferson Blvd
South Bend, IN 46615-3028

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
I20251027001509 IN Practitioner - Clinical Psychologist 2163911603 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 2025
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Reflections CounselingGroup PAC ID 1153624812, 6 clinicians

Practice addresses (Care Compare)

3220 E Jefferson Blvd
South Bend, IN 46615-3028
Phone (574) 222-2466

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Arts, Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
20044010AINMDClinical Psychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Dr Heather Holleman LLC Clinical CurrentSince May 18, 2025 Accepting new patients
Reflections Counseling CurrentSince Oct 9, 2025 Accepting new patients

Locations

3220 E Jefferson Blvd
South Bend, IN 46615
Phone (574) 222-2466

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": "1747353600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1763942400000",
    "number": "1710778899",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3220 E JEFFERSON BLVD",
            "city": "SOUTH BEND",
            "state": "IN",
            "postal_code": "466153028"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3220 E JEFFERSON BLVD",
            "city": "SOUTH BEND",
            "state": "IN",
            "postal_code": "466153028",
            "telephone_number": "574-222-2466"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LASKI",
        "first_name": "JOSEPH",
        "middle_name": "NATHAN",
        "credential": "MA",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2025-05-16",
        "last_updated": "2025-11-24",
        "certification_date": "2025-11-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "IN",
            "license": "20044010A",
            "primary": false
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "IN",
            "license": "20044010A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in South Bend, IN

Sources for this page

Verify at the official NPI Registry.