Individual provider Active NPI

Dana Lynn Samardzich, LHMC, NCC, PCC

  • Mental Health Counselor
  • Valparaiso, IN
National Provider Identifier
1902404619
Registry record updated Sep 4, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
39004643A Issued in IN
Practice address
1158 Lincolnway Ste 3
Valparaiso, IN 46385-5802
Phone
(192) 203-3225
NPI assigned
Oct 14, 2020
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 4, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X 39004643A IN Primary

Addresses

Primary practice location

1158 Lincolnway Ste 3
Valparaiso, IN 46385-5802

Mailing address

1158 Lincolnway Ste 3
Valparaiso, IN 46385-5802
Phone (192) 203-3225

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

LicenseStateTypeSpecialty
39004643AINMDMental Health Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Professional Counseling and Coaching LLC Mental Health CurrentSince Oct 22, 2023 Accepting new patients

Locations

1158 Lincolnway
Ste 3
Valparaiso, IN 46385
Phone (219) 203-3225

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1602633600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1693785600000",
    "number": "1902404619",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1158 LINCOLNWAY STE 3",
            "city": "VALPARAISO",
            "state": "IN",
            "postal_code": "463855802",
            "telephone_number": "192-203-3225"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1158 LINCOLNWAY STE 3",
            "city": "VALPARAISO",
            "state": "IN",
            "postal_code": "463855802",
            "telephone_number": "192-203-3225"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SAMARDZICH",
        "first_name": "DANA",
        "middle_name": "LYNN",
        "credential": "LHMC, NCC, PCC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-10-14",
        "last_updated": "2023-09-04",
        "certification_date": "2023-09-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "IN",
            "license": "39004643A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Valparaiso, IN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 4, 2023; 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.