GLENIS A SUNDBERG (NPI# 1083988547) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1083988547 |
Entity Type | Individual |
Full Name | GLENIS A SUNDBERG |
Credential | MS. ED; LMFT |
Practice Address |
1818 Carew St Ste 320 Fort Wayne IN 46805-4764 |
Mailing Address |
3702 New Vision Dr Bldg B Fort Wayne IN 46845-1703 |
Practice Telephone | 2603735890 |
Practice Fax Number | 2604228444 |
Enumeration Date | 2012-03-01 |
Last Update Date | 2019-06-13 |
Gender Code | F |
Is Sole Proprietor | Y |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 106H00000X | Marriage & Family Therapist | 35001823A | IN | Behavioral Health & Social Service Providers |
Street Address |
1818 CAREW ST STE 320 |
City | FORT WAYNE |
State | IN |
Zip Code | 46805-4764 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1558855197 | Nicole Pitts | Physician Assistant | 1818 Carew St Ste 320, Fort Wayne, IN 46805-4764 | 2018-06-18 |
1801339791 | Alyssa L. Germann | Physician Assistant | 1818 Carew St Ste 320, Fort Wayne, IN 46805-4764 | 2016-11-23 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1619589546 | Connor Gemlick | Student in an Organized Health Care Education/Training Program | 1918 Carew St., Fort Wayne, IN 46805 | 2020-08-21 |
1710464086 | S.t.a.r. Care Services | Clinic/Center | 3521 Lake Avenue, Suite #4, Fort Wayne, IN 46805 | 2018-07-19 |
1083122865 | Noel Shafi | Counselor | 3010 East State Boulevard, Fort Wayne, IN 46805 | 2018-01-16 |
1063963627 | Toni L Irby | Specialist | 3219 E State Blvd, Fort Wayne, IN 46805 | 2016-10-19 |
1639626211 | Logan Schwerer | Pharmacist | 923 Northcrest Business Center 6d, Fort Wayne, IN 46805 | 2016-09-01 |
1063817104 | Michale Diane Rothgeb | Physical Therapy Assistant | 2200 Randollia Dr, Fort Wayne, IN 46805 | 2014-10-31 |
1124435789 | Julia I. Mcfann | Physical Therapist | 2200 Randalia Dr, Fort Wayne, IN 46805 | 2014-07-16 |
1083036974 | Capital Senior Living Properties 4, Inc. | Assisted Living Facility | 3320 East State Boulevard, Fort Wayne, IN 46805 | 2014-01-10 |
1356772396 | Alexander James Medical Supply | Durable Medical Equipment & Medical Supplies | 2200 Lake Avenue, Suite 290, Fort Wayne, IN 46805 | 2013-12-02 |
1043595689 | Randy James Jennings | Pharmacist | 923 Northcrest Business Center, 6-d, Fort Wayne, IN 46805 | 2011-10-14 |
Find all providers in zip 46805 |
Taxonomy Code | 106H00000X |
Grouping | Behavioral Health & Social Service Providers |
Classification | Marriage & Family Therapist |
A marriage and family therapist is a person with a master's degree in marriage and family therapy, or a master's or doctoral degree in a related mental health field with substantially equivalent coursework in marriage and family therapy, who receives supervised clinical experience, or a person who meets the state requirements to practice as a marriage and family therapist. A marriage and family therapist treats mental and emotional disorders within the context of marriage and family systems. A marriage and family therapist provides mental health and counseling services to individuals, couples, families, and groups. |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1487287371 | Fort Wayne Counseling Services | Marriage & Family Therapist | 6319 Mutual Dr Ste F, Fort Wayne, IN 46825-4246 | 2020-02-19 |
1942701214 | Joshawa Todd Torres | Marriage & Family Therapist | 5651 Coventry Ln # 116, Fort Wayne, IN 46804 | 2018-02-22 |
1922497775 | Mary Lisa Barta LLC | Marriage & Family Therapist | 5630 The Prophets Pass, Fort Wayne, IN 46845-9473 | 2015-01-16 |
1548506728 | Carmella Nicole Oneal | Marriage & Family Therapist | 4630 W Jefferson Blvd Ste 3, Fort Wayne, IN 46804-6800 | 2012-12-17 |
1962754523 | Matt Ryan Givens | Marriage & Family Therapist | 237 Airport North Office Park, Fort Wayne, IN 46825-6702 | 2012-10-08 |
1982982898 | Ferraro Behavior Services, LLC | Marriage & Family Therapist | 9512 Lima Rd Ste 103, Fort Wayne, IN 46818-9806 | 2011-07-26 |
1679870646 | Stephen Michael O'shaughnessy | Marriage & Family Therapist | 3407 Rolston St, Fort Wayne, IN 46805-1535 | 2011-02-27 |
1760711808 | Marjorie L Havens | Marriage & Family Therapist | 2330 Beacon St, Suite 105, Fort Wayne, IN 46805-3852 | 2009-12-21 |
1366673956 | Melissa Ann Borton | Marriage & Family Therapist | 126 W Columbia St, Ste 300, Fort Wayne, IN 46802-1719 | 2009-07-31 |
1972769735 | Mary Lisa Barta | Marriage & Family Therapist | 10315e Dawson's Creek Blvd, Fort Wayne, IN 46825-1721 | 2008-07-31 |
Find all providers in FORT WAYNE |
City | FORT WAYNE |
Zip Code | 46805 |
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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.