Healthcare Provider Details

I. General information

NPI: 1396433066
Provider Name (Legal Business Name): ADRIANNA K. NERI MA, LCPC, LMHC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/01/2023
Last Update Date: 04/26/2026
Certification Date: 04/26/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

101 W 18TH ST
LA PORTE IN
46350-6830
US

IV. Provider business mailing address

512 ANDREW AVE # 120
LA PORTE IN
46350-4633
US

V. Phone/Fax

Practice location:
  • Phone: 219-369-2341
  • Fax:
Mailing address:
  • Phone: 219-916-1593
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number180.016789
License Number StateIL
# 2
Primary TaxonomyN
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number39005410A
License Number StateIN
# 3
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number39005410A
License Number StateIN
# 4
Primary TaxonomyN
Taxonomy Code101Y00000X
TaxonomyCounselor
License Number180.016789
License Number StateIL
# 5
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number180.016789
License Number StateIL
# 6
Primary TaxonomyN
Taxonomy Code101Y00000X
TaxonomyCounselor
License Number39005410A
License Number StateIN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: