RANDY NIMS (NPI# 1437289469) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1437289469 |
| Entity Type | Individual |
| Full Name | RANDY NIMS |
| Credential | MA |
| Practice Address |
701 N Niles Ave South Bend IN 46617-1923 |
| Mailing Address |
403 E Madison St South Bend IN 46617-2322 |
| Practice Telephone | 5742831107 |
| Practice Fax Number | 5742831131 |
| Mailing Telephone | 5742831107 |
| Mailing Fax Number | 5742831131 |
| Enumeration Date | 2007-03-07 |
| Last Update Date | 2007-07-08 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 101Y00000X | Counselor | Behavioral Health & Social Service Providers |
| Street Address |
701 N NILES AVE |
| City | SOUTH BEND |
| State | IN |
| Zip Code | 46617-1923 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1659842490 | South Bend Behavioral Health LLC | Clinic/Center | 701 N Niles Ave, South Bend, IN 46617-1923 | 2018-12-05 |
| 1447753801 | Carrie Curtis | Behavior Technician | 701 N Niles Ave, South Bend, IN 46617-1923 | 2018-03-13 |
| 1366965485 | Riverbend Behavioral Health, LLC | Residential Treatment Facility, Emotionally Disturbed Children | 701 N Niles Ave, South Bend, IN 46617-1923 | 2017-07-20 |
| 1215467006 | Riverbend Behavioral Health, LLC | Behavioral Analyst | 701 N Niles Ave, South Bend, IN 46617-1923 | 2017-06-14 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1740731116 | Jack Mcintyre Kimmell | Specialist/Technologist | 1526 East Lasalle, South Bend, IN 46617 | 2016-10-20 |
| 1023429115 | Morning View Assisted Living LLC | Assisted Living Facility | 475 N. Niles Avenue, South Bend, IN 46617 | 2014-05-12 |
| 1265861231 | Rebecca Busenbark | Physical Therapist | 401 E Colfax Ave Ste 102, South Bend, IN 46617 | 2013-11-11 |
| 1962709071 | Doreen Danice Huddleston | Social Worker | 928 East Wayne St, Suit C, South Bend, IN 46617 | 2011-02-25 |
| 1487981734 | Mary Cecilia Roemer | Marriage & Family Therapist | 616 E. Colfax Ave, South Bend, IN 46617 | 2009-11-06 |
| 1225264054 | Sridhar Meda | Dentist | 1005 East Lasalle Ave, South Bend, IN 46617 | 2009-06-08 |
| 1063673531 | Madeline Christina Watkins | Counselor | 616 E Colfax, South Bend, IN 46617 | 2008-06-18 |
| 1437366481 | Michael Reed Johns | Dentist | 103 South Eddy Street, South Bend, IN 46617 | 2007-05-17 |
| 1194937680 | Sarah Elizabeth Redman | Specialist/Technologist | 53880 Carmichael Dr., South Bend, IN 46617 | 2007-05-04 |
| 1124241211 | Trixy Franke | Family Medicine | 837 E. Cedar St., Ste 100, South Bend, IN 46617 | 2007-04-10 |
| Find all providers in zip 46617 | ||||
| Taxonomy Code | 101Y00000X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Counselor |
| A provider who is trained and educated in the performance of behavior health services through interpersonal communications and analysis. Training and education at the specialty level usually requires a master’s degree and clinical experience and supervision for licensure or certification. |
| Notes: Sources: Abridged from definitions provided by the National Board of Certified Counselors and the American Association of Pastoral Counselors. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1770191892 | Baochun Hind | Counselor | 1205 E Bronson St, South Bend, IN 46615-1141 | 2020-07-15 |
| 1356820765 | Roniqua Teshae Roundtree | Counselor | 53174 Flowing Stream Ct, South Bend, IN 46628-9034 | 2018-08-08 |
| 1760909840 | Precious Pals Inc | Counselor | 1139 E Lasalle Ave, South Bend, IN 46617-3321 | 2017-08-29 |
| 1780053546 | Jonathan Rosengren | Counselor | 415 E Madison Street, South Bend, IN 46617-1109 | 2015-09-22 |
| 1225283039 | Jody L. Hughes | Counselor | 202 S. Michigan Street, Suite 875, South Bend, IN 46601 | 2008-11-20 |
| 1063673531 | Madeline Christina Watkins | Counselor | 616 E Colfax, South Bend, IN 46617 | 2008-06-18 |
| 1609906593 | Jenifer R Hill | Counselor | 227n Dixie Way 140, South Bend, IN 46637-3300 | 2007-03-07 |
| 1396873147 | Barbara Lynn Miller | Counselor | 5024 W Western Ave, South Bend, IN 46619-2312 | 2007-03-02 |
| 1255472643 | Deborah Kay Clardy | Counselor | 53846 Generations Dr, South Bend, IN 46635-1543 | 2007-02-09 |
| 1407855414 | Kristine A. Thelen | Counselor | 108 N Main St, Suite 305, South Bend, IN 46601-1625 | 2005-07-20 |
| Find all providers in SOUTH BEND | ||||
| City | SOUTH BEND |
| Zip Code | 46617 |
Please comment or provide details below to improve the information on RANDY NIMS.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.