Organization Active NPI

Danielle R Allen LCSW LLC

  • Clinical Social Worker
  • Fort Wayne, IN
National Provider Identifier
1013645985
Registry record updated Aug 28, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
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

Updated by the provider on Aug 28, 2023

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Ms. Danielle Renee Allen, LCSWNPI 1821528878
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)CodeLicenseStatePrimary
Clinical Social WorkerGroup: 193400000X SINGLE SPECIALTY GROUP 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

IdentifierTypeStateIssuer
1821528878OtherINNPI

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IN

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
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 Directory

Locations

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.

Verify at the official NPI Registry.