Healthcare Provider Details

I. General information

NPI: 1265112049
Provider Name (Legal Business Name): ASCEND COUNSELING NWI LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/18/2023
Last Update Date: 07/18/2023
Certification Date: 07/14/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

320 S CALUMET RD
CHESTERTON IN
46304-2451
US

IV. Provider business mailing address

709-2 PLAZA DRIVE 146
CHESTERTON IN
46304
US

V. Phone/Fax

Practice location:
  • Phone: 219-316-2217
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261QM0855X
TaxonomyAdolescent and Children Mental Health Clinic/Center
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code324500000X
TaxonomySubstance Abuse Rehabilitation Facility
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code3245S0500X
TaxonomyChildren's Substance Abuse Rehabilitation Facility
License Number
License Number State

VIII. Authorized Official

Name: LINDEN GRECULA
Title or Position: FOUNDER
Credential:
Phone: 219-316-2217