# MENTAL HEALTH AMERICA WABASH VALLEY REGION

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Mental Health America of Tippecanoe, Mental Health America
- **Organization subpart:** No

## Provider details

- **NPI number:** 1760088850
- **Authorized official:** BRANDI CHRISTIANSEN (PRESIDENT AND CEO)
- **Authorized official phone:** (765) 742-1800

## Contact information

- **Practice address:** 914 SOUTH ST, LAFAYETTE, IN 47901-1416
- **Practice address phone:** (765) 742-1800
- **Mailing address:** 914 SOUTH ST, LAFAYETTE, IN 47901-1416
- **Mailing address phone:** (765) 742-1800

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 101YA0400X | Addiction (Substance Use Disorder) Counselor | — | NULL | — |
| 101YA0400X | Addiction (Substance Use Disorder) Counselor | — | — | — |
| 101YM0800X | Mental Health Counselor | — | NULL | — |
| 101YM0800X | Mental Health Counselor | — | — | — |
| 103TC0700X | Clinical Psychologist | — | NULL | — |
| 103TC0700X | Clinical Psychologist | — | — | — |
| 1041C0700X | Clinical Social Worker | — | NULL | — |
| 1041C0700X | Clinical Social Worker | — | — | — |
| 171M00000X | Case Manager/Care Coordinator | — | NULL | Yes |
| 171M00000X | Case Manager/Care Coordinator | — | — | Yes |
| 172A00000X | Driver | — | NULL | — |
| 172A00000X | Driver | — | — | — |
| 172V00000X | Community Health Worker | — | NULL | — |
| 172V00000X | Community Health Worker | — | — | — |
| 175T00000X | Peer Specialist | — | NULL | — |
| 175T00000X | Peer Specialist | — | — | — |

## Other

- **Enumeration date:** 12/05/2020
- **Last updated:** 12/05/2020