Indigo Counseling Services, Inc

Primary specialty

CounselorTaxonomy code 101Y00000X

License

S1050 Issued in OH

Legal business name

INDIGO COUNSELING SERVICES, INC

Practice address

1230 Lexington Ave Ste 100
Mansfield, OH 44907-2679

Phone

(419) 775-1771

Fax

(419) 775-1088

NPI assigned

Aug 7, 2014

Organization subpart

No

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

Authorized official

Name

Gregg Richards, LPCC

Title

President

Phone

(419) 775-1771

Specialties & licenses 3

Addresses

Locations

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

{
    "created_epoch": "1407369600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1407369600000",
    "number": "1821407503",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1230 LEXINGTON AVE STE 100",
            "city": "MANSFIELD",
            "state": "OH",
            "postal_code": "449072679",
            "telephone_number": "419-775-1771",
            "fax_number": "419-775-1088"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1230 LEXINGTON AVE STE 100",
            "city": "MANSFIELD",
            "state": "OH",
            "postal_code": "449072679",
            "telephone_number": "419-775-1771",
            "fax_number": "419-775-1088"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "INDIGO COUNSELING SERVICES, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-08-07",
        "last_updated": "2014-08-07",
        "status": "A",
        "authorized_official_last_name": "RICHARDS",
        "authorized_official_first_name": "GREGG",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "419-775-1771",
        "authorized_official_credential": "LPCC"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor",
            "state": "OH",
            "license": "S1050",
            "primary": true
        },
        {
            "code": "103T00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychologist",
            "state": "OH",
            "license": "4741",
            "primary": false
        },
        {
            "code": "103TA0400X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychologist, Addiction (Substance Use Disorder)",
            "state": "OH",
            "license": "892648",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Counselor in Mansfield, OH
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• Counselor in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 7, 2014; 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.