IMANI INGRAM (NPI# 1912381575) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1912381575 |
| Entity Type | Individual |
| Full Name | IMANI INGRAM |
| Credential | MPA, ACIT |
| Practice Address |
4218 W Western Ave South Bend IN 46619-2622 |
| Practice Telephone | 5742331524 |
| Mailing Telephone | 5742331524 |
| Enumeration Date | 2015-07-14 |
| Last Update Date | 2015-07-14 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 101YA0400X |
Counselor Specialization: Addiction (Substance Use Disorder) |
Behavioral Health & Social Service Providers |
| Street Address |
4218 W WESTERN AVE |
| City | SOUTH BEND |
| State | IN |
| Zip Code | 46619-2622 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1497798284 | Victory Clinical Services II LLC | Psychologist | 4218 W Western Ave, South Bend, IN 46619-2622 | 2006-06-13 |
| 1578190815 | Jeremy Sean Molica | Counselor | 4218 W Western Ave, South Bend, IN 46619-2622 | 2020-03-26 |
| 1306472659 | Kelly Franklin | Counselor | 4218 W Western Ave, South Bend, IN 46619-2622 | 2020-03-19 |
| 1730689027 | Melissa Lewis | Counselor | 4218 W Western Ave, South Bend, IN 46619-2622 | 2018-02-14 |
| 1811388424 | John Anthony Krecek | Counselor | 4218 W Western Ave, South Bend, IN 46619-2622 | 2015-02-18 |
| 1679988893 | Joie Wroblewski | Counselor | 4218 W Western Ave, South Bend, IN 46619-2622 | 2014-06-26 |
| 1467667733 | Andrew R. Guljas | Psychologist | 4218 W Western Ave, South Bend, IN 46619-2617 | 2007-05-11 |
| 1386858629 | Erin T. Lacourt | Counselor | 4218 W Western Ave, South Bend, IN 46619-2617 | 2007-05-09 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1578015103 | Martin's Super Markets, Inc. | Pharmacy | 525 S. Mayflower Rd, South Bend, IN 46619 | 2016-10-31 |
| 1124449053 | Sandra J Jackson | Counselor | 4218 Western Ave., South Bend, IN 46619 | 2013-12-19 |
| 1902227911 | Patricia Ann Miller | Counselor | 4218 Western Ave, South Bend, IN 46619 | 2013-12-17 |
| 1740611953 | Cynthia G. Finney | Counselor | 4218 Western Avenue, So Bend, IN 46619 | 2013-12-13 |
| 1437433406 | Angela Nicole Zolvinski | Pharmacist | 4444 W. Western Ave, South Bend, IN 46619 | 2011-10-07 |
| 1871674556 | The Health and Hospital Corporation of Marion County | Skilled Nursing Facility | 4600 W Washington St, South Bend, IN 46619 | 2006-10-18 |
| 1942302203 | April Holtgren | Family Medicine | 1901 #b Western Ave, South Bend, IN 46619 | 2006-09-05 |
| 1447737002 | Graciela Jimenez-martinez | Registered Nurse | 1901 #b Western Avenue, South Bend, IN 46619 | 2018-07-25 |
| 1821397878 | Wright Dream | In Home Supportive Care | 706 S Sheridan St, South Bend, IN 46619 | 2011-03-16 |
| 1740439223 | Scott J. Vanslambrouck | Dentist | 1901 #b Western Avenue, Ihc South Bend, South Bend, IN 46619 | 2008-09-09 |
| Find all providers in zip 46619 | ||||
| Taxonomy Code | 101YA0400X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Counselor |
| Specialization | Addiction (Substance Use Disorder) |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1346632957 | Joel A Mccleary | Counselor | 17815 Woodthrush Ln, South Bend, IN 46635-1329 | 2015-02-19 |
| 1295123693 | Perry Minner Jr. | Counselor | 430 E Lasalle Ave, South Bend, IN 46617-2724 | 2015-01-07 |
| 1124449053 | Sandra J Jackson | Counselor | 4218 Western Ave., South Bend, IN 46619 | 2013-12-19 |
| 1902227911 | Patricia Ann Miller | Counselor | 4218 Western Ave, South Bend, IN 46619 | 2013-12-17 |
| 1730526823 | Thomas Eugene Hoff | Counselor | 1409 Enchanted Forest St, South Bend, IN 46637-4730 | 2013-05-29 |
| 1174738439 | Pearl A. Anderson | Counselor | 4005 W Western Ave, South Bend, IN 46619-2617 | 2007-05-11 |
| 1972629327 | Pamela H Forsey | Counselor | 2319 Edison Rd, South Bend, IN 46615-3515 | 2007-03-21 |
| 1578190815 | Jeremy Sean Molica | Counselor | 4218 W Western Ave, South Bend, IN 46619-2622 | 2020-03-26 |
| 1700420023 | Rachael Elizabeth Amor | Counselor | 3606 E Jefferson Blvd, South Bend, IN 46615-3052 | 2019-10-30 |
| 1821593989 | Keilah Ehrman | Counselor | 1102 Fellows St, South Bend, IN 46601-3514 | 2018-03-29 |
| Find all providers in SOUTH BEND | ||||
| City | SOUTH BEND |
| Zip Code | 46619 |
Please comment or provide details below to improve the information on IMANI INGRAM.
| 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.