Individual provider Active NPI

Amber M. Hiss, MSW, LCSW

  • Mental Health Counselor
  • Fort Wayne, IN
National Provider Identifier
1063977833
Registry record updated Feb 4, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
34009252A Issued in IN
Practice address
2622 Lake Ave Ste 1
Fort Wayne, IN 46805-5410
Phone
(260) 299-3160
NPI assigned
Feb 6, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 4, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X 34009252A IN Primary

Addresses

Primary practice location

2622 Lake Ave Ste 1
Fort Wayne, IN 46805-5410

Mailing address

240 N Tillotson Ave
Muncie, IN 47304-3988
Phone (765) 288-1928

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IN
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20210503000311 IN Practitioner - Clinical Social Worker 2860801990 Reassigns benefits to 3 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Meridian Health Services Corp CurrentSince Dec 7, 2024 Accepting new patients
Alliance Health Centers Inc. CurrentSince Sep 12, 2022 Accepting new patients
Bowen Health Inc CurrentSince Apr 13, 2021 Accepting new patients
Bowen Health Inc CurrentSince Apr 13, 2021 Accepting new patients
Meridian Health Services Corp. CurrentSince Dec 7, 2024 Accepting new patients
Alliance Health Centers, Inc. CurrentSince Sep 12, 2022 Accepting new patients

Locations

119 W Market St
Columbia City, IN 46725
Phone (260) 248-8176

2700 Lafayette St
Ste 110
Fort Wayne, IN 46806
Phone (260) 660-0780

2020 McKinnie Ave
Fort Wayne, IN 46806

2622 Lake Ave
Ste 1
Fort Wayne, IN 46805
Phone (260) 299-3160

240 N Tillotson Ave
Muncie, IN 47304

850 N Harrison St
Warsaw, IN 46580
Phone (219) 267-7169

2621 E Jefferson St
Warsaw, IN 46580
Phone (574) 269-0573

Interoperability endpoints

  • Direct secure messaging: amber.hiss.p1@direct.meridianhs.nextgenshare.com

Organizations & group practices 6

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.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1549411200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1738627200000",
    "number": "1063977833",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "240 N TILLOTSON AVE",
            "city": "MUNCIE",
            "state": "IN",
            "postal_code": "473043988",
            "telephone_number": "765-288-1928"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2622 LAKE AVE STE 1",
            "city": "FORT WAYNE",
            "state": "IN",
            "postal_code": "468055410",
            "telephone_number": "260-299-3160"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HISS",
        "first_name": "AMBER",
        "middle_name": "M.",
        "credential": "MSW, LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-02-06",
        "last_updated": "2025-02-04",
        "certification_date": "2025-02-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "IN",
            "license": "34009252A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Wayne, IN

Sources for this page

Verify at the official NPI Registry.