Liberation Ministries Inc

Primary specialty

Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X

Legal business name

LIBERATION MINISTRIES INC

Practice address

3901 N. College Ave
Suite 135
Indianapolis, IN 46205-2764

Phone

(317) 789-6108

Fax

(317) 931-0943

NPI assigned

Aug 21, 2006

Organization subpart

No

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

Authorized official

Name

Jacqueline Carroll, LMHCNPI 1851431258

Title

Ceo

Phone

(317) 789-6108

Specialties & licenses 9

Addresses

Other identifiers 2

Other names 1

• Rise & Excel Counseling & Community Services Doing business as

Tax ID family

Liberation Ministries Inc3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

Organizations that report the same tax identification number in the National Provider Directory.

• Liberation Ministries Inc

  • Professional Counselor
  • Indianapolis, IN
  • NPI 1295433597
  NPD tax ID
• Liberation Ministries Inc

  • Mental Health Counselor
  • Indianapolis, IN
  • NPI 1558069682
  NPD tax ID

Locations

Subparts reporting this organization as parent 3

Organizations that report themselves as subparts in NPPES and name this organization, in the same state, as their parent.

• Liberation Ministries Inc

  • Professional Counselor
  • Indianapolis, IN
  • NPI 1295433597
  NPPES parent name
• Liberation Ministries Inc

  • Mental Health Counselor
  • Indianapolis, IN
  • NPI 1558069682
  NPPES parent name
• Rise & Excel Counseling & Community Services

  • Non-emergency Medical Transport (VAN)
  • Indianapolis, IN
  • NPI 1144495979
  NPPES parent name

Practitioners 2

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

• Jacqueline Carroll, LMHC

  • Counselor
  • Indianapolis, IN
  • NPI 1851431258
  NPD (past) Authorized official
• Deidra Joel Loyd, MSW

  • Social Worker
  • Indianapolis, IN
  • NPI 1477600237
  NPD (past)

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

{
    "created_epoch": "1156118400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1671062400000",
    "number": "1972618452",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3903 N. COLLEGE AVENUE",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462052734",
            "telephone_number": "317-789-6108",
            "fax_number": "317-931-0943"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3901 N. COLLEGE AVE",
            "address_2": "SUITE 135",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462052764",
            "telephone_number": "317-789-6108",
            "fax_number": "317-931-0943"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LIBERATION MINISTRIES INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-21",
        "last_updated": "2022-12-15",
        "certification_date": "2022-12-15",
        "status": "A",
        "authorized_official_last_name": "CARROLL",
        "authorized_official_first_name": "JACQUELINE",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "317-789-6108",
        "authorized_official_credential": "LMHC"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "101YA0400X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "101YP1600X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Pastoral",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Professional",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "103TB0200X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychologist, Cognitive & Behavioral",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychologist, Clinical",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "103TC1900X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychologist, Counseling",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "104100000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Social Worker",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200493540",
            "state": "IN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "300022920",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Rise & Excel Counseling & Community Services",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Kevin Liao, PHARMD
• Mark Liao, MD
• Amanda M Libak, PT
• Liberation Ministries Inc
• Liberation Ministries Inc
• Brianna M Liberio, M.D.
• Libertad Counseling
• Liberty Care LLC Dba Sovereign Care Services
• Mathew J Libke, MD
• Amanda Liby, MS, CCC-SLP

• 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 Dec 15, 2022; 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.