Active NPI
Galen Arthur Yordy, PHD
- Counseling Psychologist
- Fort Wayne, IN
National Provider Identifier
1053488197
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Counseling Psychologist
- License
- 20040712
- Practice address
- 2805 Fairfield Ave
Fort Wayne, IN 46807-1218 - Phone
- (260) 456-4880
- Fax
- (260) 456-3559
- NPI assigned
- Nov 30, 2006
- Sex
- Male
- 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 |
|---|---|---|---|---|
| Counseling Psychologist | 103TC1900X | 20040712 | IN | Primary |
Addresses
Primary practice location
2805 Fairfield Ave
Fort Wayne, IN 46807-1218
Mailing address
225 N Seminole Cir
Fort Wayne, IN 46807-2864
Phone (260) 744-1682
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 100332280 | Medicaid | IN |
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)
- Enrolled
- Credentials
- Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 20040712 | IN | MD | Counseling Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1164844800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1203465600000",
"number": "1053488197",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "225 N SEMINOLE CIR",
"city": "FORT WAYNE",
"state": "IN",
"postal_code": "468072864",
"telephone_number": "260-744-1682",
"fax_number": "260-422-1555"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2805 FAIRFIELD AVE",
"city": "FORT WAYNE",
"state": "IN",
"postal_code": "468071218",
"telephone_number": "260-456-4880",
"fax_number": "260-456-3559"
}
],
"practiceLocations": [],
"basic": {
"last_name": "YORDY",
"first_name": "GALEN",
"middle_name": "ARTHUR",
"name_prefix": "Dr.",
"credential": "PHD",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-11-30",
"last_updated": "2008-02-20",
"status": "A"
},
"taxonomies": [
{
"code": "103TC1900X",
"taxonomy_group": "",
"desc": "Psychologist, Counseling",
"state": "IN",
"license": "20040712",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "100332280",
"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 Feb 20, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.