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
- 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 and National Provider Directory roles.
-
- Mental Health Counselor
- Fort Wayne, IN
- NPI 1326111444
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.