Provider Demographics
NPI:1083788426
Name:LINCOLN COUNSELING, PC
Entity Type:Organization
Organization Name:LINCOLN COUNSELING, PC
Other - Org Name:LINCOLN THERAPEUTIC PARTNERSHIP
Other - Org Type:Doing Business As
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MS
Authorized Official - First Name:JEANNINE
Authorized Official - Middle Name:M
Authorized Official - Last Name:CURTIS
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:574-255-4976
Mailing Address - Street 1:220 W COLFAX AVE STE 400
Mailing Address - Street 2:
Mailing Address - City:SOUTH BEND
Mailing Address - State:IN
Mailing Address - Zip Code:46601-1635
Mailing Address - Country:US
Mailing Address - Phone:574-255-4976
Mailing Address - Fax:574-255-1882
Practice Address - Street 1:220 W COLFAX AVE STE 400
Practice Address - Street 2:
Practice Address - City:SOUTH BEND
Practice Address - State:IN
Practice Address - Zip Code:46601-1635
Practice Address - Country:US
Practice Address - Phone:574-255-4976
Practice Address - Fax:574-255-1882
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-18
Last Update Date:2022-10-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN68000016A101Y00000X, 101YM0800X, 104100000X, 1041C0700X, 106H00000X, 104100000X
261QM0801X, 261QM0855X
IN680000016A261QM0850X, 261QM0855X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes104100000XBehavioral Health & Social Service ProvidersSocial WorkerGroup - Multi-Specialty
No101Y00000XBehavioral Health & Social Service ProvidersCounselorGroup - Multi-Specialty
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty
No1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Multi-Specialty
No106H00000XBehavioral Health & Social Service ProvidersMarriage & Family TherapistGroup - Multi-Specialty
No261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)Group - Multi-Specialty
No261QM0850XAmbulatory Health Care FacilitiesClinic/CenterAdult Mental HealthGroup - Multi-Specialty
No261QM0855XAmbulatory Health Care FacilitiesClinic/CenterAdolescent and Children Mental HealthGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN000000341216OtherANTHEM
IN200475040BMedicaid
IN200021670Medicaid
IN740606000OtherMAGELLAN
IN200475040AMedicaid
IN399077OtherMHN
IN7014575OtherAETNA
IN399077OtherMHN
IN7014575OtherAETNA
IN200475040BMedicaid