MARISSA K FRESON (NPI# 1336574656) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1336574656 |
| Entity Type | Individual |
| Full Name | MARISSA K FRESON |
| Credential | MSED, LMFTA |
| Practice Address |
2525 Lake Ave Fort Wayne IN 46805-5407 |
| Practice Telephone | 2604844153 |
| Practice Fax Number | 2604965996 |
| Mailing Telephone | 2604844153 |
| Mailing Fax Number | 2604965996 |
| Enumeration Date | 2013-09-05 |
| Last Update Date | 2015-04-15 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 101YM0800X |
Counselor Specialization: Mental Health |
Behavioral Health & Social Service Providers |
| Street Address |
2525 LAKE AVE |
| City | FORT WAYNE |
| State | IN |
| Zip Code | 46805-5407 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1699868893 | Crossroad - Fort Wayne Childrens Home | Residential Treatment Facility, Emotionally Disturbed Children | 2525 Lake Ave, Fort Wayne, IN 46805-5407 | 2006-10-02 |
| 1215491519 | Jeff Newman | Case Manager/Care Coordinator | 2525 Lake Ave, Fort Wayne, IN 46805-5407 | 2019-01-31 |
| 1861956161 | Patricia Carol Ward | Case Manager/Care Coordinator | 2525 Lake Ave, Fort Wayne, IN 46805-5407 | 2019-01-31 |
| 1063996551 | Sarah Noreen York | Case Manager/Care Coordinator | 2525 Lake Ave, Fort Wayne, IN 46805-5407 | 2018-09-20 |
| 1841774346 | Candis Lea Luchnenko | Case Manager/Care Coordinator | 2525 Lake Ave, Fort Wayne, IN 46805-5407 | 2018-09-20 |
| 1093299976 | Alan Dale Shupe | Case Manager/Care Coordinator | 2525 Lake Ave, Fort Wayne, IN 46805-5407 | 2018-09-18 |
| 1962985424 | Matthew Brooks Flinn | Case Manager/Care Coordinator | 2525 Lake Ave, Fort Wayne, IN 46805-5407 | 2018-09-11 |
| 1962984260 | Jon Robert Moseby | Case Manager/Care Coordinator | 2525 Lake Ave, Fort Wayne, IN 46805-5407 | 2018-09-04 |
| 1497236442 | Katrina Louise Imber | Case Manager/Care Coordinator | 2525 Lake Ave, Fort Wayne, IN 46805-5407 | 2018-08-28 |
| 1487135869 | Jackie Dean Vannatta Jr. | Case Manager/Care Coordinator | 2525 Lake Ave, Fort Wayne, IN 46805-5407 | 2018-08-24 |
| Find all providers in the same location | ||||
| 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 | 101YM0800X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Counselor |
| Specialization | Mental Health |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1548881899 | Emily H Cook | Counselor | 2130 Pemberton Dr, Fort Wayne, IN 46805-4628 | 2020-04-28 |
| 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 |
| Find all providers in FORT WAYNE | ||||
| City | FORT WAYNE |
| Zip Code | 46805 |
Please comment or provide details below to improve the information on MARISSA K FRESON.
| 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.