| Northern Indiana Therapies | |
|
804 Monroe St La Porte IN 46350-3511 | |
| (219) 229-0109 | |
| Not Available |
| Full Name | Northern Indiana Therapies |
|---|---|
| Speciality | Clinic/Center |
| Location | 804 Monroe St, La Porte, Indiana |
| Authorized Official Name and Position | Valerie Weber (OWNER) |
| Authorized Official Contact | 2192290109 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Northern Indiana Therapies 4953 W Concord Dr La Porte IN 46350-7241 Ph: (219) 229-0109 | Northern Indiana Therapies 804 Monroe St La Porte IN 46350-3511 Ph: (219) 229-0109 |
| NPI Number | 1316356504 |
|---|---|
| Provider Enumeration Date | 08/12/2014 |
| Last Update Date | 08/09/2022 |
| Certification Date | 08/09/2022 |
| Medicare PECOS PAC ID | 7517333206 |
|---|---|
| Medicare Enrollment ID | O20221020002963 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1316356504 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YM0800X | Counselor - Mental Health | (* (Not Available)) | Secondary |
| 261QM1300X | Clinic/center - Multi-specialty | (* (Not Available)) | Primary |
| Provider Name | Paula Anderson |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1518517929 PECOS PAC ID: 8325414014 Enrollment ID: I20221020003026 |
| Provider Name | Carl Hufford |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1396482287 PECOS PAC ID: 9931575651 Enrollment ID: I20221021000632 |
| Provider Name | Robert Dale Owens |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1528381407 PECOS PAC ID: 3173973054 Enrollment ID: I20231219003284 |
| Provider Name | Valerie Weber |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1255476156 PECOS PAC ID: 0244606937 Enrollment ID: I20240104004239 |
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