Active NPI
Danielle R Allen LCSW LLC
- Clinical Social Worker
- Fort Wayne, IN
National Provider Identifier
1013645985
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- Legal business name
- DANIELLE R ALLEN LCSW LLC
- Practice address
- 1027 W Rudisill Blvd Ste 210
Fort Wayne, IN 46807-2160 - Phone
- (260) 750-0341
- NPI assigned
- Aug 9, 2022
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Ms. Danielle Renee Allen, LCSW
- Title
- Officer
- Phone
- (260) 750-0341
Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | Primary |
Addresses
Primary practice location
1027 W Rudisill Blvd Ste 210
Fort Wayne, IN 46807-2160
Mailing address
11511 Green Holly CV
Fort Wayne, IN 46845-2018
Phone (260) 750-0341
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1821528878 | Other | IN | NPI |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in IN
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20221220001209 | IN | Part B Supplier - Clinic/Group Practice | 1052780715 |
Receives reassigned benefits from 1 practitioner Practice locations: Fort Wayne, IN |
National Provider Directory
National Provider DirectoryLocations
1027 W Rudisill Blvd
Ste 210
Fort Wayne, IN 46807
Phone (260) 750-0341
1025 W Rudisill Blvd
Fort Wayne, IN 46807
Practitioners & affiliated clinicians
Practitioners 1
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1660003200000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1693180800000",
"number": "1013645985",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "11511 GREEN HOLLY CV",
"city": "FORT WAYNE",
"state": "IN",
"postal_code": "468452018",
"telephone_number": "260-750-0341"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1027 W RUDISILL BLVD STE 210",
"city": "FORT WAYNE",
"state": "IN",
"postal_code": "468072160",
"telephone_number": "260-750-0341"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "DANIELLE R ALLEN LCSW LLC",
"organizational_subpart": "NO",
"enumeration_date": "2022-08-09",
"last_updated": "2023-08-28",
"certification_date": "2023-08-28",
"status": "A",
"authorized_official_last_name": "ALLEN",
"authorized_official_first_name": "DANIELLE",
"authorized_official_middle_name": "RENEE",
"authorized_official_title_or_position": "OFFICER",
"authorized_official_telephone_number": "260-750-0341",
"authorized_official_name_prefix": "Ms.",
"authorized_official_credential": "LCSW"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Social Worker, Clinical",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "NPI",
"identifier": "1821528878",
"state": "IN"
}
],
"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 28, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.