Active NPI
George W Blount Jr., MSW LMHC
- Counselor
- South Bend, IN
National Provider Identifier
1871645382
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Counselor
- License
- 39001415A
- Practice address
- 108 N Main St
Suite 500
South Bend, IN 46601 - Phone
- (574) 246-1244
- Fax
- (574) 246-1250
- NPI assigned
- Jan 17, 2007
- Last updated
- Jul 8, 2007
- 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 |
|---|---|---|---|---|
| Counselor | 101Y00000X | 39001415A | IN | Primary |
Addresses
Primary practice location
108 N Main St
Suite 500
South Bend, IN 46601
Mailing address
330 W Lexington Ave
Suite 206
Elkhart, IN 46516
Phone (574) 293-5991
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 |
|---|---|---|---|
| 39001415A | IN | MD | Counselor |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Bonhomie Counseling Corp | Counselor | Past | Accepting new patients |
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
- Counselor
- Elkhart, IN
- NPI 1033289277
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1168992000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1871645382",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "330 W LEXINGTON AVE",
"address_2": "SUITE 206",
"city": "ELKHART",
"state": "IN",
"postal_code": "46516",
"telephone_number": "574-293-5991",
"fax_number": "574-293-5429"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "108 N MAIN ST",
"address_2": "SUITE 500",
"city": "SOUTH BEND",
"state": "IN",
"postal_code": "46601",
"telephone_number": "574-246-1244",
"fax_number": "574-246-1250"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BLOUNT",
"first_name": "GEORGE",
"middle_name": "W",
"name_prefix": "Mr.",
"name_suffix": "Jr.",
"credential": "MSW LMHC",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2007-01-17",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "101Y00000X",
"taxonomy_group": "",
"desc": "Counselor",
"state": "IN",
"license": "39001415A",
"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 Jul 8, 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.