CENTER FOR BRIEF THERAPY PC (NPI# 1285839480) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1285839480 |
| Entity Type | Organization |
| Organization Name | CENTER FOR BRIEF THERAPY PC |
| Other Organization Name | INDIANA CENTER FOR COGNITIVE BEHAVIOR THERAPY |
| Practice Address |
423 Airport N. Office Park Ft. Wayne IN 46825-6704 |
| Mailing Address |
423 Airport N. Office Park Fort. Wayne IN 46825-6704 |
| Practice Telephone | 2609695583 |
| Practice Fax Number | 2609695584 |
| Mailing Telephone | 2609695583 |
| Mailing Fax Number | 2609695584 |
| Enumeration Date | 2007-06-18 |
| Last Update Date | 2019-04-23 |
| Authorized Official Name | SHARON E FREEMAN CLEVENGER (OWNER) |
| Authorized Official Telephone | 2609695583 |
| Authorized Official Credential | PMHCNS-BC |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 103TH0100X |
Psychologist Specialization: Health Service |
20042050A | IN | Behavioral Health & Social Service Providers |
| N | 106H00000X | Marriage & Family Therapist | 35001565A | IN | Behavioral Health & Social Service Providers |
| Y | 103TP0016X |
Psychologist Specialization: Prescribing (Medical) |
70000153A | IN | Behavioral Health & Social Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| IN | ANTHEM | 376137 | 01 |
| IN | ANTHEM | 386107 | 01 |
| IN | AETNA | 7585825 | 01 |
| Other Name | Type Code |
|---|---|
| Indiana Center for Cognitive Behavior Therapy | Doing Business As Name - Organization |
| Street Address |
423 AIRPORT N. OFFICE PARK |
| City | FT. WAYNE |
| State | IN |
| Zip Code | 46825-6704 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1336772078 | Bradley Murphy | Occupational Therapist | 2626 St Joe Center Ed, Fort Wayne, IN 46825 | 2020-02-21 |
| 1144851015 | Sabryna Roman | Developmental Therapist | 2626 St Joe Center Rd, Fort Wayne, IN 46825 | 2020-01-30 |
| 1205474103 | Ashleigh Miller | Developmental Therapist | 2626 St. Joe Center Rd, Fort Wayne, IN 46825 | 2019-12-11 |
| 1962055152 | Carehalo Ohio LLC | General Practice | 2510 Dupont Circle Dr., Suite 201, Fort Wayne, IN 46825 | 2019-07-17 |
| 1306318175 | Logan Alan Williams | Nurse Anesthetist, Certified Registered | 10315 Dawsons Creek Blvd Ste B, Fort Wayne, IN 46825 | 2018-12-18 |
| 1326582925 | Mark F Stoner LLC | Dentist | 9830 Auburn Rd Suite 102, Fort Wayne, IN 46825 | 2016-12-15 |
| 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 |
| Find all providers in zip 46825 | ||||
| Taxonomy Code | 103TP0016X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Psychologist |
| Specialization | Prescribing (Medical) |
| Those licensed psychologists who have completed specialized, post-doctoral training in psychopharmacology, passed a national proficiency examination in psychopharmacology, and who are authorized by state statute to prescribe medications, in accordance with their state law and state licensing authority, for the evaluation, diagnosis, management and treatment of mental, nervous, emotional, behavioral, and related disorders. |
| Notes: Source: Louisiana Academy of Medical Psychologists Note: Some states issue licenses under Medical Psychologist. [1/1/2007: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1033612551 | Dallas M Hunsberger | Psychologist | 2118 Milburn Blvd, Mishawaka, IN 46544-4521 | 2018-03-11 |
| 1932441631 | Illiana Psychiatric Associates | Psychologist | 2010 E Columbus Dr, East Chicago, IN 46312-2830 | 2013-03-20 |
| 1891919783 | St.vincent Anderson Regional Hospital | Psychologist | 2015 Jackson St, Anderson, IN 46016-4337 | 2007-04-12 |
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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.