KRISTINE HAWORTH CONNERLY (NPI# 1053450940) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1053450940 |
| Entity Type | Individual |
| Full Name | KRISTINE HAWORTH CONNERLY |
| Credential | LMFT,LSW |
| Practice Address |
2712 S Calhoun St Fort Wayne IN 46807-1402 |
| Practice Telephone | 2607444326 |
| Practice Fax Number | 2607440188 |
| Mailing Telephone | 2607444326 |
| Mailing Fax Number | 2607440188 |
| Enumeration Date | 2007-02-06 |
| Last Update Date | 2007-07-08 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| X | 104100000X | Social Worker | 33001557A | IN | Behavioral Health & Social Service Providers |
| X | 106H00000X | Marriage & Family Therapist | 35000747A | IN | Behavioral Health & Social Service Providers |
| Street Address |
2712 S CALHOUN ST |
| City | FORT WAYNE |
| State | IN |
| Zip Code | 46807-1402 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1609868504 | Therese C Mihlbauer | Psychologist | 2712 S Calhoun St, Fort Wayne, IN 46807-1402 | 2005-08-17 |
| 1134731425 | Paige L Zehr | Counselor | 2712 S Calhoun St, Fort Wayne, IN 46807-1402 | 2020-08-19 |
| 1013481027 | Tracy B. Hershberger | Counselor | 2712 S Calhoun St, Fort Wayne, IN 46807-1402 | 2019-01-14 |
| 1871061887 | Ruth G. Davis | Social Worker | 2712 S Calhoun St, Fort Wayne, IN 46807-1402 | 2018-11-07 |
| 1487108254 | Kim Rozier | Counselor | 2712 S Calhoun St, Fort Wayne, IN 46807-1402 | 2016-08-10 |
| 1144664574 | Vanessa Jones | Counselor | 2712 S Calhoun St, Fort Wayne, IN 46807-1402 | 2013-04-29 |
| 1619216389 | Elizabeth Porter | Counselor | 2712 S Calhoun St, Fort Wayne, IN 46807-1402 | 2013-01-31 |
| 1770758591 | Melissa K Sezginer | Counselor | 2712 S Calhoun St, Fort Wayne, IN 46807-1402 | 2008-04-23 |
| 1245370360 | Diana Moore | Counselor | 2712 S Calhoun St, Fort Wayne, IN 46807-1402 | 2007-02-07 |
| 1902945819 | Ruth Bracht | Counselor | 2712 S Calhoun St, Fort Wayne, IN 46807-1402 | 2007-02-06 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1982234191 | Erin Hall | Case Manager/Care Coordinator | 5800 Faifield, Fort Wayne, IN 46807 | 2020-01-16 |
| 1912208745 | Lezly A Scott | Counselor | 2417 Fairfield Ave., Attn: Lezly Scott, Fort Wayne, IN 46807 | 2010-11-10 |
| 1851749147 | Eric Shoemaker | Family Medicine | 1007 W Rudisill Blvd, Fort Wayne, IN 46807 | 2016-05-27 |
| 1821464603 | Emily Nicole Ackerman | Physical Therapist | 5800 Fairfield Ave, Ste 150, Fort Wayne, IN 46807 | 2015-08-17 |
| 1477639698 | John P Crowley | Social Worker | 2805 Fairfield Ave, Fort Wayne, IN 46807 | 2006-10-31 |
| 1770131948 | Donzhae Lee | Student in an Organized Health Care Education/Training Program | 2510 Thompson Ave, Fort Wayne, IN 46807-1051 | 2019-08-30 |
| 1407919236 | The Arc of Northeast Indiana Inc. | Intermediate Care Facility, Mentally Retarded | 2522 Thompson Ave, Fort Wayne, IN 46807-1051 | 2006-12-19 |
| 1770725244 | Clinical Services, LLC | Clinic/Center | 2315 Broadway, Fort Wayne, IN 46807-1103 | 2009-03-30 |
| 1831252592 | Rosie T Milner | Nurse Practitioner | 2315 Broadway, Fort Wayne, IN 46807-1103 | 2006-12-17 |
| 1558379453 | James Curtis Potts | Dentist | 2703 Broadway, James C Potts Dds, Fort Wayne, IN 46807-1111 | 2006-08-04 |
| Find all providers in zip 46807 | ||||
| Taxonomy Code | 104100000X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Social Worker |
| A social worker is a person who is qualified by a Social Work degree, and licensed, certified or registered by the state as a social worker to practice within the scope of that license. A social worker provides assistance and counseling to clients and their families who are dealing with social, emotional and environmental problems. Social work services may be rendered to individuals, families, groups, and the public. |
| Notes: Source: National Association of Social Workers, 2009 [7/1/2009: definition modified] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1710587548 | Laura Raquel Rochford | Social Worker | 3702 New Vision Dr Bldg B, Fort Wayne, IN 46845-1703 | 2020-10-30 |
| 1801407689 | Hand Along The Way, LLC | Social Worker | 4118 Sandhurst Dr, Fort Wayne, IN 46815-5430 | 2020-08-13 |
| 1588200604 | Shalynn Grace Bailey | Social Worker | 2625 Medford Dr, Fort Wayne, IN 46803-3132 | 2019-11-24 |
| 1912363375 | Jay Alan Bastian | Social Worker | 5004 Woodhurst Blvd, Fort Wayne, IN 46807-3134 | 2016-01-14 |
| 1669757225 | Denise Jensen | Social Worker | 12306 Goldeneyes Ct, Fort Wayne, IN 46845-9160 | 2011-10-14 |
| 1679743033 | Sandra Ellen Chauhan | Social Worker | 8708 Woodstream Dr, Fort Wayne, IN 46804-6564 | 2008-03-01 |
| 1184815102 | James Scott Ferraro | Social Worker | 12527 Carroll Creek Run, Fort Wayne, IN 46818-8780 | 2007-08-06 |
| 1487870531 | Michelle A. Hoffman | Social Worker | Lutheran Hospital- Social Services, 7950 W. Jefferson Blvd., Fort Wayne, IN 46804 | 2007-04-17 |
| 1417083486 | Deborah Mcculloch | Social Worker | 3737 Lake Ave, Fort Wayne, IN 46805-5554 | 2007-02-26 |
| 1063432425 | Diana Lynn Pierce | Social Worker | 10305 Dawsons Creek Blvd Ste C, Fort Wayne, IN 46825-1914 | 2006-07-20 |
| Find all providers in FORT WAYNE | ||||
| City | FORT WAYNE |
| Zip Code | 46807 |
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| 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.