Individual provider Active NPI

Rachida Bejja, MSED, LMHC

  • Mental Health Counselor
  • Fort Wayne, IN
National Provider Identifier
1013232172
Registry record updated Aug 17, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
39002384A Issued in IN
Practice address
10828 Coldwater Rd
Fort Wayne, IN 46845-1241
Phone
(260) 415-8267
Fax
(260) 426-0270
NPI assigned
Apr 1, 2010
Sex
Female
Sole proprietor
No

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.

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

State licenses

LicenseStateTypeSpecialty
39002384AINMDMental Health Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Quality Counseling & Psychological Services, LLC Mental Health Past Accepting new patients

Specialties & licenses 2

NPPES NPI Registry
Specialty (taxonomy)CodeLicenseStatePrimary
Professional Counselor 101YP2500X 655-3-1-10A ND
Mental Health Counselor 101YM0800X 39002384A IN Primary

Addresses

NPPES NPI Registry

Primary practice location

10828 Coldwater Rd
Fort Wayne, IN 46845-1241

Mailing address

10828 Coldwater Rd
Fort Wayne, IN 46845-1241
Phone (260) 415-8267

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Aug 17, 2012.

{
    "created_epoch": "1270080000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1345161600000",
    "number": "1013232172",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10828 COLDWATER RD",
            "city": "FORT WAYNE",
            "state": "IN",
            "postal_code": "468451241",
            "telephone_number": "260-415-8267",
            "fax_number": "260-426-0270"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10828 COLDWATER RD",
            "city": "FORT WAYNE",
            "state": "IN",
            "postal_code": "468451241",
            "telephone_number": "260-415-8267",
            "fax_number": "260-426-0270"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BEJJA",
        "first_name": "RACHIDA",
        "credential": "MSED, LMHC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-04-01",
        "last_updated": "2012-08-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "ND",
            "license": "655-3-1-10A",
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "IN",
            "license": "39002384A",
            "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 Aug 17, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.