Individual provider Active NPI

Emiley M Rogers-Bly, LMHC

  • Mental Health Counselor
  • Kendallville, IN
National Provider Identifier
1750628343
Registry record updated Jan 16, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
39002418A Issued in IN
Practice address
1930 Dowling St
Kendallville, IN 46755-9436
Phone
(260) 347-4400
Fax
(260) 347-3122
NPI assigned
Jan 16, 2013
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 16, 2013

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 39002418A IN Primary

Addresses

Primary practice location

1930 Dowling St
Kendallville, IN 46755-9436

Mailing address

PO Box 817
220 S Main St
Kendallville, IN 46755-0817
Phone (260) 347-2453

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
I20240405001240 IN Practitioner - Mental Health Counselor 5698113900 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 2009
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Northeastern Center IncGroup PAC ID 6709795636, 24 clinicians

Practice addresses (Care Compare)

1930 Dowling St
Kendallville, IN 46755-9436
Phone (260) 347-4400

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
39002418AINMDMental Health Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Northeastern Center, Inc CurrentSince Mar 26, 2024 Accepting new patients
Northeastern Center Inc CurrentSince Mar 26, 2024 Accepting new patients

Locations

220 S Main St
Kendallville, IN 46755
Phone (219) 347-4400

1930 Dowling St
Kendallville, IN 46755
Phone (260) 347-4400

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": "1358294400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1358294400000",
    "number": "1750628343",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 817",
            "address_2": "220 S MAIN ST",
            "city": "KENDALLVILLE",
            "state": "IN",
            "postal_code": "467550817",
            "telephone_number": "260-347-2453",
            "fax_number": "260-347-2456"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1930 DOWLING ST",
            "city": "KENDALLVILLE",
            "state": "IN",
            "postal_code": "467559436",
            "telephone_number": "260-347-4400",
            "fax_number": "260-347-3122"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROGERS-BLY",
        "first_name": "EMILEY",
        "middle_name": "M",
        "credential": "LMHC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-01-16",
        "last_updated": "2013-01-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "IN",
            "license": "39002418A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Kendallville, IN

Sources for this page

Verify at the official NPI Registry.