Provider Demographics
NPI:1184356925
Name:GERKIN COUNSELING, INC
Entity type:Organization
Organization Name:GERKIN COUNSELING, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:COO
Authorized Official - Prefix:
Authorized Official - First Name:SHANDI
Authorized Official - Middle Name:
Authorized Official - Last Name:GERKIN
Authorized Official - Suffix:
Authorized Official - Credentials:LMHC
Authorized Official - Phone:812-797-0620
Mailing Address - Street 1:743 N NEWTON ST
Mailing Address - Street 2:
Mailing Address - City:BEDFORD
Mailing Address - State:IN
Mailing Address - Zip Code:47421-1737
Mailing Address - Country:US
Mailing Address - Phone:812-797-0620
Mailing Address - Fax:
Practice Address - Street 1:229 INDIANA AVE
Practice Address - Street 2:
Practice Address - City:OOLITIC
Practice Address - State:IN
Practice Address - Zip Code:47451-9616
Practice Address - Country:US
Practice Address - Phone:812-797-0620
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-06-29
Last Update Date:2022-06-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)Group - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN300053389Medicaid