Frieda Lorraine Spoolstra, LMHC

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

39002314A Issued in IN

Practice address

5900 Hohman Ave
Hammond, IN 46320-2423

Phone

(219) 931-0427

Fax

(219) 937-5808

NPI assigned

Feb 23, 2007

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

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

Medicare enrollment (NPD)

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.

• Southlake Community Mental Health Center Inc.

  • Clinic/Center
  • Merrillville, IN
  • NPI 1821081290
  Medicare reassignment NPD

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

{
    "created_epoch": "1172188800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1319414400000",
    "number": "1831225192",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8400 LOUISIANA ST",
            "city": "MERRILLVILLE",
            "state": "IN",
            "postal_code": "464106385",
            "telephone_number": "219-757-1928",
            "fax_number": "219-757-1950"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5900 HOHMAN AVE",
            "city": "HAMMOND",
            "state": "IN",
            "postal_code": "463202423",
            "telephone_number": "219-931-0427",
            "fax_number": "219-937-5808"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SPOOLSTRA",
        "first_name": "FRIEDA",
        "middle_name": "LORRAINE",
        "credential": "LMHC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-02-23",
        "last_updated": "2011-10-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "IN",
            "license": "39002314A",
            "primary": true
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "IL",
            "license": "180004845",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Southlake Community Mental Health Center Inc.
• Southlake Community Mental Health Center, Inc
• Southlake Community Mental Health Center, Inc.
• Southlake Community Mental Health Center, Inc.
• Yolanda A Spencer, NP
• Lisa A. Spudic, MS, RN, FNP
• St Margaret Mercy Healthcare
• St Margaret Mercy Healthcare Centers
• St Margaret Mercy Healthcare Centers
• St Margaret Mercy Healthcare Centers

• Mental Health Counselor in Hammond, IN
• Providers in Hammond, IN by specialty
• Mental Health Counselor in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 24, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.