Active NPI
Alicia Jean Digiulio, MA, MSED, LMHC
- Mental Health Counselor
- Fort Wayne, IN
National Provider Identifier
1003200775
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Mental Health Counselor
- License
- 39003727A
- Practice address
- 9417 Saint Joe Center Rd
Fort Wayne, IN 46835-9259 - Phone
- (260) 255-5289
- NPI assigned
- Mar 20, 2015
- Last updated
- Mar 11, 2020
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | 39003727A | IN | Primary |
Addresses
Primary practice location
9417 Saint Joe Center Rd
Fort Wayne, IN 46835-9259
Mailing address
13720 Pendleton Mills CT
Fort Wayne, IN 46814-8998
Phone (260) 348-6394
Other practice location 1
2020 E Washington Blvd Ste 700
Fort Wayne, IN 46803-1368
Phone (260) 422-3034
Other practice location 2
6202 Constitution Dr Ste B
Fort Wayne, IN 46804-1583
Phone (260) 255-5289
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Master of Arts
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 39003727A | IN | MD | Mental Health Counselor |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Edt, Inc. | Mental Health | Past | Accepting new patients |
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1426809600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1583884800000",
"number": "1003200775",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "13720 PENDLETON MILLS CT",
"city": "FORT WAYNE",
"state": "IN",
"postal_code": "468148998",
"telephone_number": "260-348-6394"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "9417 SAINT JOE CENTER RD",
"city": "FORT WAYNE",
"state": "IN",
"postal_code": "468359259",
"telephone_number": "260-255-5289"
}
],
"practiceLocations": [
{
"address_1": "2020 E Washington Blvd Ste 700",
"address_purpose": "LOCATION",
"city": "Fort Wayne",
"state": "IN",
"postal_code": "468031368",
"country_code": "US",
"telephone_number": "260-422-3034",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "6202 Constitution Dr Ste B",
"address_purpose": "LOCATION",
"city": "Fort Wayne",
"state": "IN",
"postal_code": "468041583",
"country_code": "US",
"telephone_number": "260-255-5289",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "DIGIULIO",
"first_name": "ALICIA",
"middle_name": "JEAN",
"credential": "MA, MSED, LMHC",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2015-03-20",
"last_updated": "2020-03-11",
"certification_date": "2020-03-11",
"status": "A"
},
"taxonomies": [
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": "IN",
"license": "39003727A",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Fort Wayne, IN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 11, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.