Integrated Mental Health and Addiction Treatment Services

Primary specialty

Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X

Legal business name

INTEGRATED MENTAL HEALTH AND ADDICTION TREATMENT SERVICES

Practice address

3430 Cork Bend Dr
Indianapolis, IN 46239-7669

Phone

(317) 966-7772

NPI assigned

Feb 5, 2025

Organization subpart

No

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

Authorized official

Name

Kimtoiya O Sam, LCACNPI 1639622467

Title

Owner

Phone

(317) 966-7772

Specialties & licenses 1

Addresses

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Kimtoiya Oneal Sam, LCAC

  • Addiction (Substance Use Disorder) Counselor
  • Indianapolis, IN
  • NPI 1639622467
  NPD Authorized official

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

{
    "created_epoch": "1738713600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1738713600000",
    "number": "1962216275",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3430 CORK BEND DR",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462397669",
            "telephone_number": "317-966-7772"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3430 CORK BEND DR",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462397669",
            "telephone_number": "317-966-7772"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "INTEGRATED MENTAL HEALTH AND ADDICTION TREATMENT SERVICES",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-02-05",
        "last_updated": "2025-02-05",
        "certification_date": "2025-02-05",
        "status": "A",
        "authorized_official_last_name": "SAM",
        "authorized_official_first_name": "KIMTOIYA",
        "authorized_official_middle_name": "O",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "317-966-7772",
        "authorized_official_credential": "LCAC"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Addiction (Substance Use Disorder) Counselor in Indianapolis, IN
• Providers in Indianapolis, IN by specialty
• Addiction (Substance Use Disorder) Counselor in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 5, 2025; 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.