Active NPI
Jason K Richmond, LMHC
- Social Worker
- Indianapolis, IN
National Provider Identifier
1811933039
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Social Worker
- License
- 39000741
- Practice address
- 2620 Kessler Boulevard East Dr
Suite 210
Indianapolis, IN 46220-2890 - Phone
- (317) 475-6200
- Fax
- (317) 475-6212
- NPI assigned
- Jun 22, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Social Worker | 104100000X | 39000741 | IN | Primary |
Addresses
Primary practice location
2620 Kessler Boulevard East Dr
Suite 210
Indianapolis, IN 46220-2890
Mailing address
250 N Shadeland Ave
Suite 200
Indianapolis, IN 46219-4959
Phone (317) 962-4836
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
| License | State | Type | Specialty |
|---|---|---|---|
| 39000741 | IN | MD | Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1150934400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1193097600000",
"number": "1811933039",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "250 N SHADELAND AVE",
"address_2": "SUITE 200",
"city": "INDIANAPOLIS",
"state": "IN",
"postal_code": "462194959",
"telephone_number": "317-962-4836",
"fax_number": "317-962-8646"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2620 KESSLER BOULEVARD EAST DR",
"address_2": "SUITE 210",
"city": "INDIANAPOLIS",
"state": "IN",
"postal_code": "462202890",
"telephone_number": "317-475-6200",
"fax_number": "317-475-6212"
}
],
"practiceLocations": [],
"basic": {
"last_name": "RICHMOND",
"first_name": "JASON",
"middle_name": "K",
"name_prefix": "Mr.",
"credential": "LMHC",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-06-22",
"last_updated": "2007-10-23",
"status": "A"
},
"taxonomies": [
{
"code": "104100000X",
"taxonomy_group": "",
"desc": "Social Worker",
"state": "IN",
"license": "39000741",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Indianapolis, IN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 23, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.