Catholic Charities Diocese of Gary Inc

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

56030098 50243 Issued in IN

Legal business name

CATHOLIC CHARITIES DIOCESE OF GARY INC

Practice address

321 E 11TH St
Michigan City, IN 46360-3641

Phone

(219) 879-9312

Fax

(219) 879-9073

NPI assigned

Mar 6, 2007

Last updated

Oct 30, 2013By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Kenneth M. Flanagan, PH.D

Title

Diocesan Director

Phone

(219) 663-8417

Specialties & licenses 1

Addresses

Other identifiers 1

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

{
    "created_epoch": "1173139200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1383091200000",
    "number": "1891825394",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "176 S WEST ST",
            "city": "CROWN POINT",
            "state": "IN",
            "postal_code": "463073906",
            "telephone_number": "219-663-8417",
            "fax_number": "219-663-8421"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "321 E 11TH ST",
            "city": "MICHIGAN CITY",
            "state": "IN",
            "postal_code": "463603641",
            "telephone_number": "219-879-9312",
            "fax_number": "219-879-9073"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CATHOLIC CHARITIES DIOCESE OF GARY INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-06",
        "last_updated": "2013-10-30",
        "status": "A",
        "authorized_official_last_name": "FLANAGAN",
        "authorized_official_first_name": "KENNETH",
        "authorized_official_middle_name": "M.",
        "authorized_official_title_or_position": "DIOCESAN DIRECTOR",
        "authorized_official_telephone_number": "219-663-8417",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PH.D"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "IN",
            "license": "56030098 50243",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200085310",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 30, 2013; 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.