Healthcare Provider Details

I. General information

NPI: 1215719828
Provider Name (Legal Business Name): SIMON MICAH ANDERSON SCHELLING MSW, LCSW
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/18/2023
Last Update Date: 12/17/2025
Certification Date: 12/17/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

954 EASTPORT CENTRE DR STE A
VALPARAISO IN
46383-4456
US

IV. Provider business mailing address

954 EASTPORT CENTRE DR STE B
VALPARAISO IN
46383-4456
US

V. Phone/Fax

Practice location:
  • Phone: 219-386-3386
  • Fax: 219-245-6115
Mailing address:
  • Phone: 219-386-3386
  • Fax: 219-245-6115

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code104100000X
TaxonomySocial Worker
License Number34012538A
License Number StateIN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: