Active NPI
Jeremy M. Linton, PH.D.
- Mental Health Counselor
- South Bend, IN
National Provider Identifier
1952450595
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Mental Health Counselor
- License
- 39001667A
- Practice address
- 2012 Ironwood Cir
South Bend, IN 46635-1888 - Phone
- (574) 273-2743
- Fax
- (574) 273-2746
- NPI assigned
- Jan 10, 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 |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | 39001667A | IN | Primary |
Addresses
Primary practice location
2012 Ironwood Cir
South Bend, IN 46635-1888
Mailing address
2012 Ironwood Cir
South Bend, IN 46635-1888
Phone (574) 273-2743
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
- Credentials
- Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 39001667A | IN | MD | Mental Health Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1168387200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1343260800000",
"number": "1952450595",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2012 IRONWOOD CIR",
"city": "SOUTH BEND",
"state": "IN",
"postal_code": "466351888",
"telephone_number": "574-273-2743",
"fax_number": "574-273-2746"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2012 IRONWOOD CIR",
"city": "SOUTH BEND",
"state": "IN",
"postal_code": "466351888",
"telephone_number": "574-273-2743",
"fax_number": "574-273-2746"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LINTON",
"first_name": "JEREMY",
"middle_name": "M.",
"name_prefix": "Dr.",
"credential": "PH.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2007-01-10",
"last_updated": "2012-07-26",
"status": "A"
},
"taxonomies": [
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": "IN",
"license": "39001667A",
"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 26, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.