Rebeca G Ackermann, MSED, LMFT

Individual provider Active NPI Marriage & Family Therapist · Fort Wayne, IN

NPI 1013267897 · NPPES record last updated Nov 25, 2014

Key facts

NPI
1013267897
Entity type
Individual (NPI type 1)
Primary specialty
Marriage & Family Therapist 106H00000X
License
35001855A (IN)
Practice address
2100 Goshen Rd
Fort Wayne, IN 46808-1493
Phone
(260) 471-3500
Fax
(260) 471-4263
NPI assigned
Sep 19, 2012
Sex
Female
Sole proprietor
No

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
35001855AINMDMarriage & Family Therapist

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X
Marriage & Family Therapist 106H00000X 35001855A IN Yes

Addresses

Primary practice location

2100 Goshen Rd
Fort Wayne, IN 46808-1493

Mailing address

2621 E Jefferson St
C/O Anne Lawson - Credentialing
Warsaw, IN 46580-3880
Phone (574) 269-0573

Other providers in Fort Wayne, IN

All providers in Fort Wayne, IN · Marriage & Family Therapist in Indiana

Sources for this page

Verify at the official NPI Registry.