Doug A Essex, LCAC
Individual provider Active NPI Counselor · Lafayette, IN
NPI 1962445387 · NPPES record last updated Oct 6, 2011
Key facts
- NPI
- 1962445387
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Counselor 101Y00000X
- Practice address
- 610 Main Street
Lafayette, IN 47901 - Phone
- (765) 423-2638
- NPI assigned
- Jun 14, 2006
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 3
Medicare Care Compare profile
- Specialty
- Mental Health Counselor
- Education
- Other, 2002
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
Practice addresses (Care Compare)
115 N Green St
Suite 102
Crawfordsville, IN 47933-1708
Phone (765) 231-5672
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in IN
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: No · Power mobility devices: No · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20250804003136 | IN | Practitioner - Mental Health Counselor | 2365950060 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Mesa Waa Gii, LLC | Current |
Accepting new patients | |
| Shades of Recovery LLC | Addiction (Substance Use Disorder) | Current | Accepting new patients |
| Rockville Recovery LLC | Past | Accepting new patients |
Locations
115 N Green St
Ste 102
Crawfordsville, IN 47933
Phone (765) 231-5672
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Counselor | 101Y00000X | Yes | ||
| Addiction (Substance Use Disorder) Counselor | 101YA0400X | IN |
Addresses
Primary practice location
610 Main Street
Lafayette, IN 47901
Mailing address
202 E Main St
PO Box 376
Ladoga, IN 47954-9799
Phone (765) 942-2182
Other providers in Lafayette, IN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Oct 6, 2011. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.