Amelia Mendota, LSW, PMH-C, CD/BDT

Primary specialty

Social WorkerTaxonomy code 104100000X

License

33011813A Issued in IN

Practice address

2613 E 3Rd St
Bloomington, IN 47401-5345

Phone

(812) 727-0134

Fax

(812) 245-1118

NPI assigned

Apr 18, 2022

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other names 1

• Molly Mendota Other name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Locations

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.

• Tandem Community Birth Center and Postpartum House, Inc.

  • Birthing Clinic/Center
  • Bloomington, IN
  • NPI 1942949003
  NPD

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

{
    "created_epoch": "1650240000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1711843200000",
    "number": "1821731878",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "401 E ALLEN ST",
            "city": "BLOOMINGTON",
            "state": "IN",
            "postal_code": "474015915",
            "telephone_number": "812-272-7278"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2613 E 3RD ST",
            "city": "BLOOMINGTON",
            "state": "IN",
            "postal_code": "474015345",
            "telephone_number": "812-727-0134",
            "fax_number": "812-245-1118"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "401 E Allen St",
            "address_purpose": "LOCATION",
            "city": "Bloomington",
            "state": "IN",
            "postal_code": "474015915",
            "country_code": "US",
            "telephone_number": "812-272-7278",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "333 E Miller Dr",
            "address_purpose": "LOCATION",
            "city": "Bloomington",
            "state": "IN",
            "postal_code": "474016557",
            "country_code": "US",
            "telephone_number": "812-353-3214",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MENDOTA",
        "first_name": "AMELIA",
        "credential": "LSW, PMH-C, CD/BDT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-04-18",
        "last_updated": "2024-03-31",
        "certification_date": "2024-03-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "374J00000X",
            "taxonomy_group": "",
            "desc": "Doula",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "IN",
            "license": "33011813A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MOLLY",
            "last_name": "MENDOTA",
            "credential": "LSW, PMH-C, CD/BDT",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Melissa Stone Counseling and Consulting, LLC
• Debbie J. Melloan-Ruiz, M.S., L.S.W.
• Daveon Melton
• McKayla Melton, RBT-21-197126
• Rose Melton, RBT
• Chris Ann Meno, PH.D.
• Kevin David Mensendiek
• Mildred M Mensendiek, PT
• Ally Meraz
• Marisa Maria Mercer, NP

• Social Worker in Bloomington, IN
• Providers in Bloomington, IN by specialty
• Social Worker in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 31, 2024; 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.