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General NPI Number Information
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NPI Number | 1447249438
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Entity Type | Individual
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Provider Name | JODY ANN PASSAFUME M.ED,
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Gender | Female
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Dates
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Enumeration Date | 10/21/2005
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Last Update Date | 09/11/2025
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Provider Practice Location Address
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Address Line | 951 SOUTHPOINT CIR SUITE B
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City | VALPARAISO
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State | IN
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Zip | 46385-6265
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Country | US
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Telephone | 219-465-6518
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Fax | 219-477-6994
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Provider Business Mailing Address
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Address Line | 3695 W PAWNEE DR
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City | LAPORTE
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State | IN
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Zip | 46350-7953
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Country | US
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Telephone | 219-362-4854
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number | 39000488A
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License Number State | IN
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Taxonomy #2
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | 34002792A
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License Number State | IN
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