WILLOWGLEN ACADEMY - INDIANA (NPI# 1487858411) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1487858411 |
| Entity Type | Organization |
| Organization Name | WILLOWGLEN ACADEMY - INDIANA |
| Practice Address |
308 E 21st Ave Gary IN 46407-2618 |
| Practice Telephone | 2198861320 |
| Mailing Telephone | 2198861320 |
| Enumeration Date | 2007-06-13 |
| Last Update Date | 2020-08-22 |
| Authorized Official Name | MR. DWAYNE WARREN MUELLER (EXECUTIVE DIRECTOR) |
| Authorized Official Telephone | 2198861320 |
| Authorized Official Credential | RN |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QM0855X |
Clinic/Center Specialization: Adolescent and Children Mental Health |
53769 | IN | Ambulatory Health Care Facilities |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1417227984 | Willowglen Academy - Indiana | Residential Treatment Facility, Emotionally Disturbed Children | 2301 Jefferson St, Gary, IN 46407-3043 | 2011-12-30 |
| 1144353715 | Willowglen Academy - Indiana | Residential Treatment Facility, Emotionally Disturbed Children | 308 E 21st Ave, Gary, IN 46407-2618 | 2007-03-13 |
| 1073788113 | Willowglen Academy - Indiana | Residential Treatment Facility, Emotionally Disturbed Children | 308 E 21st Ave, Gary, IN 46407-2618 | 2008-04-29 |
| Street Address |
308 E 21ST AVE |
| City | GARY |
| State | IN |
| Zip Code | 46407-2618 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1144353715 | Willowglen Academy - Indiana | Residential Treatment Facility, Emotionally Disturbed Children | 308 E 21st Ave, Gary, IN 46407-2618 | 2007-03-13 |
| 1376974246 | Willowglen Academy-in, Inc. | Social Worker | 308 E 21st Ave, Gary, IN 46407-2618 | 2013-12-03 |
| 1023339587 | Tashena R Lollis | Social Worker | 308 E 21st Ave, Gary, IN 46407-2618 | 2010-06-18 |
| 1194046698 | Bunnie J Fleming | Licensed Practical Nurse | 308 E 21st Ave, Gary, IN 46407-2618 | 2010-06-18 |
| 1750602355 | Kecia Marie Blakely | Psychologist | 308 E 21st Ave, Gary, IN 46407-2618 | 2010-06-17 |
| 1790006302 | Darlene Roseta Tolbert | Registered Nurse | 308 E 21st Ave, Gary, IN 46407-2618 | 2010-06-17 |
| 1073834875 | Marilyn M. Caruthers | Social Worker | 308 E 21st Ave, Gary, IN 46407-2618 | 2010-06-15 |
| 1073788113 | Willowglen Academy - Indiana | Residential Treatment Facility, Emotionally Disturbed Children | 308 E 21st Ave, Gary, IN 46407-2618 | 2008-04-29 |
| 1730384207 | Alexis Nelson | Social Worker | 308 E 21st Ave, Gary, IN 46407-2618 | 2007-06-15 |
| 1598960064 | Terald Blakey | Counselor | 308 E 21st Ave, Gary, IN 46407-2618 | 2007-06-15 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1477802270 | Planned Parenthood of Indiana Gary | Clinic/Center | 1124 Broadway, Gary, IN 46407 | 2012-09-07 |
| 1891930913 | Angela Juanita Anderson | General Practice | 2353 Madison Street, Gary, IN 46407 | 2008-12-03 |
| 1548470537 | Rae Emerick | Speech-Language Pathologist | 2350 Taft Street, Gary, IN 46407 | 2007-05-22 |
| 1467577049 | Lavearn May | Registered Nurse | 308 E. 21st Avenue, Gary, IN 46407 | 2007-03-20 |
| 1881719532 | Kenneth Hicks | Social Worker | 308 East 21st Avenue, Gary, IN 46407 | 2007-03-20 |
| 1356476287 | Chube Medical Corporation | Family Medicine | 1701 Broadway, Gary, IN 46407 | 2007-02-22 |
| 1346263217 | Pulaski Memorial Hospital | Nursing Facility/Intermediate Care Facility | 700 E 21st Ave, Gary, IN 46407 | 2006-07-25 |
| 1477042505 | Ileana Green | Nurse Practitioner | 1400 Broadway, Gary, IN 46407 | 2018-05-03 |
| 1275734949 | Kenneth Edward Anderson | Speech-Language Pathologist | 2350 Taft St, Timberview Health Care Center, Gary, IN 46407 | 2007-05-30 |
| 1669555991 | David D Chube Sr. | Family Medicine | 1701 Broadway, Gary, IN 46407 | 2006-10-23 |
| Find all providers in zip 46407 | ||||
| Taxonomy Code | 261QM0855X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Adolescent and Children Mental Health |
| An entity, facility, or distinct part of a facility providing diagnostic, treatment, and prescriptive services related to mental and behavioral disorders in children and adolescents. Services may be provided to parents and family members of the patient in the form of conjoint, group, or individual therapy, and education and/or training. |
| Notes: [7/1/2003: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1447871116 | Loving Shepherd International Services & Foundation, Inc. | Clinic/Center | 1935 N Main St, Bluffton, IN 46714-1182 | 2020-05-04 |
| 1235773664 | Life Mentoring Inc. | Clinic/Center | 123 Harrington Ave Apt 2b, Crown Point, IN 46307-3843 | 2019-10-29 |
| 1265081301 | The Trauma and Addiction Treatment Center LLC | Clinic/Center | 1832 Explorer Ct, Franklin, IN 46131-6982 | 2019-09-11 |
| 1083275465 | The Academic Achievement Center, LLC | Clinic/Center | 2050 Doctors Park Dr, Columbus, IN 47203-2221 | 2019-06-26 |
| 1598263469 | Compass Counseling and Consulting Services, LLC. | Clinic/Center | 14074 Trade Center Dr Ste 247, Fishers, IN 46038-4579 | 2018-01-25 |
| 1366808834 | Change Therapy Center, LLC | Clinic/Center | 954 Eastport Centre Dr, Suite B, Valparaiso, IN 46383-4457 | 2016-01-13 |
| 1811234099 | Encouragement, LLC | Clinic/Center | 1017 Bontrager Ave, Elkhart, IN 46517-2811 | 2013-01-08 |
| 1861531386 | Zionsville Presbyterian Church | Clinic/Center | 4715 W 116th Street, Zionsville, IN 46077 | 2007-02-05 |
| 1003849605 | Ace Foster Care and Pediatric Home Nursing Agency | Clinic/Center | 7026 Indianapolis Blvd, Hammond, IN 46324-2208 | 2006-07-08 |
| 1730793530 | Choice Therapy | Clinic/Center | 12995 Star Dr, Fishers, IN 46037-5982 | 2020-08-31 |
| Find all providers with the same taxonomy | ||||
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| 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.