NPIMap

Organization Active NPI

Samaritan Family Health and Counseling Center, Inc.

  • Professional Counselor
  • South Bend, IN
National Provider Identifier
1861721136
Registry record updated Dec 16, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
Legal business name
SAMARITAN FAMILY HEALTH AND COUNSELING CENTER, INC.
Practice address
17195 Cleveland Rd
South Bend, IN 46635-1415
Phone
(574) 277-0274
Fax
(574) 271-7202
NPI assigned
Dec 16, 2009
Last updated
Dec 16, 2009By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 16, 2009

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

Authorized official

Name
Mrs. Marie Blunt, M.MIN.
Title
Executive Director
Phone
(574) 277-0274

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Professional Counselor 101YP2500X NU Primary

Addresses

Primary practice location

17195 Cleveland Rd
South Bend, IN 46635-1415

Mailing address

17195 Cleveland Rd
South Bend, IN 46635-1415
Phone (574) 277-0274

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IN

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20120106000751 IN Part B Supplier - Clinic/Group Practice 4587830807 Receives reassigned benefits from 8 practitioners
Practice locations: South Bend, IN

National Provider Directory

National Provider Directory

Locations

17195 Cleveland Rd
South Bend, IN 46635
Phone (574) 277-0274

Practitioners & affiliated clinicians

Practitioners 15

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 15

NPI Registry JSON

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

{
    "created_epoch": "1260921600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1260921600000",
    "number": "1861721136",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17195 CLEVELAND RD",
            "city": "SOUTH BEND",
            "state": "IN",
            "postal_code": "466351415",
            "telephone_number": "574-277-0274",
            "fax_number": "574-271-7202"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17195 CLEVELAND RD",
            "city": "SOUTH BEND",
            "state": "IN",
            "postal_code": "466351415",
            "telephone_number": "574-277-0274",
            "fax_number": "574-271-7202"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SAMARITAN FAMILY HEALTH AND COUNSELING CENTER, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-12-16",
        "last_updated": "2009-12-16",
        "status": "A",
        "authorized_official_last_name": "BLUNT",
        "authorized_official_first_name": "MARIE",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "574-277-0274",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "M.MIN."
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in South Bend, IN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 16, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.