Healthcare Provider Details

I. General information

NPI: 1851200463
Provider Name (Legal Business Name): SHIFTING SANDS THERAPY LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/02/2026
Last Update Date: 09/02/2026
Certification Date: 09/02/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

257 INDIANA AVE STE D7
VALPARAISO IN
46383-5504
US

IV. Provider business mailing address

257 INDIANA AVE STE D7
VALPARAISO IN
46383-5504
US

V. Phone/Fax

Practice location:
  • Phone: 219-758-1083
  • Fax:
Mailing address:
  • Phone: 219-758-1083
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number
License Number State

VIII. Authorized Official

Name: SIMON ANDERSON SCHELLING
Title or Position: OWNER
Credential: LCSW
Phone: 219-758-1083