DR. MARLA J SOUDER (NPI# 1548420474) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1548420474 |
| Entity Type | Individual |
| Full Name | DR. MARLA J SOUDER |
| Credential | PSY.D., HSPP |
| Practice Address |
11141 Parkview Plaza Dr Ste 210 Fort Wayne IN 46845-1714 |
| Mailing Address |
3702 New Vision Dr Bldg B Fort Wayne IN 46845-1703 |
| Practice Telephone | 2602665400 |
| Practice Fax Number | 2602665409 |
| Enumeration Date | 2008-06-13 |
| Last Update Date | 2019-12-04 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 103T00000X | Psychologist | 20042225A | IN | Behavioral Health & Social Service Providers |
| Y | 103TC0700X |
Psychologist Specialization: Clinical |
20042225A | IN | Behavioral Health & Social Service Providers |
| N | 103TC2200X |
Psychologist Specialization: Clinical Child & Adolescent |
20042225A | IN | Behavioral Health & Social Service Providers |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 409 E Cook Rd Ste 100, Fort Wayne, IN 468253656 | 2604874226 | 2604905433 |
| Street Address |
11141 PARKVIEW PLAZA DR STE 210 |
| City | FORT WAYNE |
| State | IN |
| Zip Code | 46845-1714 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1437674207 | Caitlyn M Alvar | Registered Nurse | 11141 Parkview Plaza Dr Ste 210, Fort Wayne, IN 46845-1714 | 2017-08-14 |
| 1154872653 | Amanda M Leisure | Nurse Practitioner | 11141 Parkview Plaza Dr Ste 210, Fort Wayne, IN 46845-1714 | 2016-10-19 |
| 1467816934 | Dustin Diller | Nurse Practitioner | 11141 Parkview Plaza Dr Ste 210, Fort Wayne, IN 46845 | 2016-04-11 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1881154110 | Nancy Jean Ehmke | Clinical Nurse Specialist | 11151 Parkview Plaza Dr, Fort Wayne, IN 46845 | 2019-03-22 |
| 1043703903 | Kara Stackhouse | Nurse Practitioner | 11050 Parkview Plaza Drive, Fort Wayne, IN 46845 | 2018-06-14 |
| 1871082412 | Tara K Jellison | Pharmacist | 11109 Parkview Plaza Drive -- Attn Pharmacy, Fort Wayne, IN 46845 | 2018-05-09 |
| 1578097572 | Forefront Dermatology, S.c. | Dermatology | 4020 New Vision Drive, Fort Wayne, IN 46845 | 2017-04-17 |
| 1811437999 | Jessica Ann Lefever | Behavioral Analyst | 3898 New Vision Dr Ste D, Fort Wayne, IN 46845 | 2017-03-08 |
| 1033668041 | Bhi Home Care, Inc. | In Home Supportive Care | 820 Mill Lake Road, Fort Wayne, IN 46845 | 2016-10-03 |
| 1467814939 | Austin Wyss | Specialist/Technologist | 11130 Parkview Circle Drive, Ft. Wayne, IN 46845 | 2016-03-24 |
| 1154713584 | Ashley Whitcraft | Specialist/Technologist | 11130 Parkview Plaza Drive #4, Fort Wayne, IN 46845 | 2015-02-23 |
| 1275975682 | Lakshmi Mohan Viji Das | Internal Medicine | 11143 Parkview Plaza Dr Ste 311, Fort Wayne, IN 46845 | 2013-07-26 |
| 1336482496 | Mithun Mohana Shenoi | Colon & Rectal Surgery | 11104 Parkview Circle Drive Suite 320, Fort Wayne, IN 46845 | 2013-03-27 |
| Find all providers in zip 46845 | ||||
| Taxonomy Code | 103TC0700X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Psychologist |
| Specialization | Clinical |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1164052791 | Kadlec Consulting Services, LLC | Psychologist | 5525 Oak Valley Pl, Fort Wayne, IN 46845-1836 | 2020-01-23 |
| 1053628248 | Kelly Stewart Hutner | Psychologist | 11143 Parkview Plaza Dr Ste 320, Fort Wayne, IN 46845-1728 | 2010-09-09 |
| 1730495813 | Spencer Jenkins Booth | Psychologist | 6526 W Jefferson Blvd, Fort Wayne, IN 46804-6206 | 2010-08-26 |
| 1750519377 | Thomas Paul Dettmer | Psychologist | 6223 Constitution Dr, Fort Wayne, IN 46804-1517 | 2009-06-23 |
| 1750509667 | Casey Nelson | Psychologist | 1515 Magnavox Way, Fort Wayne, IN 46804-1533 | 2007-04-23 |
| 1982732491 | Shirley F Shiff | Psychologist | 8424 Victoria Woods Pl, Fort Wayne, IN 46825-6510 | 2007-02-28 |
| 1912080359 | Abigail Dormire Powers | Psychologist | 10311 Dawsons Creek Blvd, Suite F, Fort Wayne, IN 46825-1913 | 2006-10-21 |
| 1376593046 | Wayne James Von Bargen | Psychologist | 1910 Saint Joe Center Rd, Suite 44, Fort Wayne, IN 46825-5000 | 2006-05-11 |
| 1093774796 | Mcgee-lytle Inc | Psychologist | 2020 E Washington Blvd, Suite 650, Fort Wayne, IN 46803-1327 | 2006-03-21 |
| 1043283641 | Jason T. Cook | Psychologist | 7230 Engle Rd, Ste 304, Fort Wayne, IN 46804-2209 | 2006-02-13 |
| Find all providers in FORT WAYNE | ||||
| City | FORT WAYNE |
| Zip Code | 46845 |
Please comment or provide details below to improve the information on DR. MARLA J SOUDER.
| 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.