ZACHARY KYLE (NPI# 1104294180) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1104294180 |
| Entity Type | Individual |
| Full Name | ZACHARY KYLE |
| Practice Address |
3512 Stellhorn Rd Fort Wayne IN 46815 |
| Mailing Address |
Po Box 392552 Pittsburgh PA 15251-9500 |
| Practice Telephone | 2604839081 |
| Practice Fax Number | 2604939196 |
| Mailing Telephone | 5125758028 |
| Enumeration Date | 2015-09-09 |
| Last Update Date | 2019-06-25 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 101Y00000X | Counselor | Behavioral Health & Social Service Providers | ||
| Y | 1041C0700X |
Social Worker Specialization: Clinical |
34008261A | IN | Behavioral Health & Social Service Providers |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 330 Lakeview Dr, Goshen, IN 465289365 | 5745331234 | 5745372652 |
| Street Address |
3512 STELLHORN RD |
| City | FORT WAYNE |
| State | IN |
| Zip Code | 46815 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1962490839 | Peggy A Ryan | Nurse Practitioner | 3512 Stellhorn Rd, Fort Wayne, IN 46815-4631 | 2005-10-13 |
| 1952915951 | Bambi Michelle Cardinal | Registered Nurse | 3512 Stellhorn Rd, Fort Wayne, IN 46815-4631 | 2020-09-07 |
| 1700408648 | Madalene Beckner | Nurse Practitioner | 3512 Stellhorn Rd, Fort Wayne, IN 46815-4631 | 2020-05-14 |
| 1013536358 | Chanel Burns | Nurse Practitioner | 3512 Stellhorn Rd, Fort Wayne, IN 46815-4631 | 2020-04-15 |
| 1033742184 | Hamutyinei H Mamutse | Nurse Practitioner | 3512 Stellhorn Rd, Fort Wayne, IN 46815-4631 | 2020-02-18 |
| 1285273573 | Abimbola D Oluwasesin | Nurse Practitioner | 3512 Stellhorn Rd, Fort Wayne, IN 46815-4631 | 2020-01-03 |
| 1912553652 | Kara Hawkins | Social Worker | 3512 Stellhorn Rd, Fort Wayne, IN 46815-4631 | 2019-08-16 |
| 1558923417 | Todd Shaw | Nurse Practitioner | 3512 Stellhorn Rd, Fort Wayne, IN 46815-4631 | 2019-07-01 |
| 1548828338 | Deanna Forsythe | Nurse Practitioner | 3512 Stellhorn Rd, Fort Wayne, IN 46815-4631 | 2019-06-05 |
| 1629636089 | Nathan Call | Nurse Practitioner | 3512 Stellhorn Rd, Fort Wayne, IN 46815-4631 | 2019-05-31 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1306305438 | Sullivan Services, Inc. | In Home Supportive Care | 2789-b Maplecrest Rd, Fort Wayne, IN 46815 | 2019-03-18 |
| 1598250144 | Altermease Gleason | Massage Therapist | 3406 Thames Drive, Fort Wayne, IN 46815 | 2018-06-26 |
| 1881000222 | Denise Sparks | Specialist | 6415 Benham Drive, Fort Wayne, IN 46815 | 2014-07-07 |
| 1962823138 | Chad Distelrath | Physical Therapy Assistant | 1717 Maplecrest Rd, Apt 112, Fort Wayne, IN 46815 | 2013-12-13 |
| 1689943409 | Kendall Joan Labrash | Physical Therapist | 4251 Lahmeyer Rd., Fort Wayne, IN 46815 | 2011-12-22 |
| 1801179718 | Jayson Laube | Pharmacist | 6201 Stellhorn, Fort Wayne, IN 46815 | 2011-09-27 |
| 1720294432 | Muscle Therapy Clinic LLC | Massage Therapist | 6409 Georgetown North Blvd, Fort Wayne, IN 46815 | 2007-05-16 |
| 1427186436 | Legoras Conture Fashions | Prosthetic/Orthotic Supplier | 3316 Inwood Drive, Fort Wayne, IN 46815 | 2007-03-01 |
| 1932252772 | Fort Wayne Smiles PC | Dentist | 2031 Reed Road, Fort Wayne, IN 46815 | 2007-01-18 |
| 1811078538 | Timothy Doody Lynch | Dentist | 4207 Hobson Court, Fort Wayne, IN 46815 | 2006-10-18 |
| Find all providers in zip 46815 | ||||
| Taxonomy Code | 1041C0700X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Social Worker |
| Specialization | Clinical |
| A social worker who holds a master’s or doctoral degree in social work from an accredited school of social work in addition to at least two years of post-master’s supervised experience in a clinical setting. The social worker must be licensed, certified, or registered at the clinical level in the jurisdiction of practice. A clinical social worker provides direct services, including interventions focused on interpersonal interactions, intrapsychic dynamics, and life management issues. Clinical social work services are based on bio-psychosocial perspectives. Services consist of assessment, diagnosis, treatment (including psychotherapy and counseling), client-centered advocacy, consultation, evaluation, and prevention of mental illness, emotional, or behavioral disturbances. |
| Notes: Source: National Association of Social Workers, 2008 [7/1/2009: definition modified] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1154933299 | Kristina Lynn Devors | Social Worker | 7116 Chippenham Dr, Fort Wayne, IN 46818-0033 | 2020-08-19 |
| 1023636909 | Gary Scott Ralya | Social Worker | 2121 E State Blvd, Fort Wayne, IN 46805-4640 | 2020-07-08 |
| 1003444985 | Courageous Healing Inc | Social Worker | 2013 S Anthony Blvd, Fort Wayne, IN 46803-3609 | 2020-03-27 |
| 1164060653 | Brosh Inc | Social Worker | 4820 Oak Knob Run, Fort Wayne, IN 46845-8939 | 2019-12-15 |
| 1740780204 | Jay Bastian LLC | Social Worker | 9910 Dupont Circle Dr. Suite 140, Fort Wayne, IN 46825-1610 | 2018-02-20 |
| 1790291755 | Resolutions Counseling LLC | Social Worker | 13207 Hammerhill Way, Fort Wayne, IN 46845-2351 | 2017-12-28 |
| 1295256907 | Kimberly Ann Bailey | Social Worker | 5310 Merchandise Dr., Fort Wayne, IN 46814 | 2017-07-03 |
| 1306377304 | Charla Leman | Social Worker | 8011 Basswood Pl, Fort Wayne, IN 46835-4752 | 2017-03-22 |
| 1659826055 | Frank Deisler | Social Worker | 5543 S Wayne Ave, Fort Wayne, IN 46807-3128 | 2016-08-16 |
| 1013376458 | Rikki Lynn Treesh | Social Worker | 4918 Canterbury Dr, Fort Wayne, IN 46835-4102 | 2016-02-13 |
| Find all providers in FORT WAYNE | ||||
| City | FORT WAYNE |
| Zip Code | 46815 |
Please comment or provide details below to improve the information on ZACHARY KYLE.
| 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.