COMPREHENSIVE BEHAVIORAL SERVICES, LLC


Address: 2809 E Dupont Rd, Fort Wayne, IN 46825-1668
Phone: 2604925500

COMPREHENSIVE BEHAVIORAL SERVICES, LLC (NPI# 1023221207) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1023221207
Entity Type Organization
Organization Name COMPREHENSIVE BEHAVIORAL SERVICES, LLC
Practice Address 2809 E Dupont Rd
Fort Wayne
IN 46825-1668
Practice Telephone 2604925500
Practice Fax Number 2604925530
Mailing Telephone 2604925500
Mailing Fax Number 2604925530
Enumeration Date 2007-05-07
Last Update Date 2012-06-26
Authorized Official Name MRS. GAYLE BEVILL-DADA (PRESIDENT/COO)
Authorized Official Telephone 2604925500
Authorized Official Credential MS, LMHC
Is Organization Subpart N

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
N 103TC1900X Psychologist
Specialization: Counseling
2004070712A IN Behavioral Health & Social Service Providers
Y 101YM0800X Counselor
Specialization: Mental Health
39001423A IN Behavioral Health & Social Service Providers

Other Provider Identifier

State Issuer Identifier Type Code
IN 1023221207 05
IN 100332280 05
IN 1053488197 05

Office Location

Street Address 2809 E DUPONT RD
City FORT WAYNE
State IN
Zip Code 46825-1668

Providers in the same location

NPI Name Taxonomy Address Enumeration
1861744062 Associated Behavioral Health Services Inc Psychologist 2809 E Dupont Rd, Fort Wayne, IN 46825-1668 2012-10-11

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NPI Name Taxonomy Address Enumeration
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1336695782 Nadine Rene' Handy Nurse Practitioner 3978 New Vision Dr., Fort Wayne, IN 46825 2016-08-26
1558815712 Nathan Paul Miller Physical Therapist 10006 Auburn Park Dr, Fort Wayne, IN 46825 2016-08-05
1013366905 Brianna Abbott Physician Assistant 1234 E Dupont Rd Ste 7, Fort Wayne, IN 46825 2016-06-10
1003276643 Seiss, LLC Psychologist 9910 Dupont Circle Drive, Suite 140, Fort Wayne, IN 46825 2016-02-24
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Taxonomy Information

Taxonomy Code 101YM0800X
Grouping Behavioral Health & Social Service Providers
Classification Counselor
Specialization Mental Health

Taxonomy Definition

Definition to come...

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NPI Name Taxonomy Address Enumeration
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1871113274 At Your Pace Counseling, LLC Counselor 6717 Sky Blue Dr, Fort Wayne, IN 46804-4648 2020-04-26
1962049809 Lynne Beardsley Counselor 4630 W Jefferson Blvd Ste 11, Fort Wayne, IN 46804-6856 2019-12-10
1578108767 Wholistic Wellness Counseling and Consulting LLC Counselor 1129 Rivermet Ave, Fort Wayne, IN 46805-4232 2019-11-11
1922654722 Nicole Conrad Counselor 908 Manck Dr, Fort Wayne, IN 46814-8995 2019-08-16
1336794148 Healing Through Art Counselor 3521 Lake Ave # B1, Fort Wayne, IN 46805-5536 2019-08-08
1013578749 A.w. Holdings, LLC Counselor 3900 Hursh Rd, Fort Wayne, IN 46845-9677 2019-06-24
1811450646 Living Waters Peace Center Counselor 3262 Mallard Cove Ln Ste B, Fort Wayne, IN 46804-2883 2019-04-09
1447718325 Victoria Lynn Prokop Counselor 4656 W Jefferson Blvd Ste 210, Fort Wayne, IN 46804-6884 2019-03-09
1811467632 Believe Counseling and Consulting Counselor 2200 Lake Ave Ste 140, Fort Wayne, IN 46805-5351 2018-12-05
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Competitor

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City FORT WAYNE
Zip Code 46825

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Dataset Information

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.

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