Active NPI
Haley Darr
- Mental Health Counselor
- Fort Wayne, IN
National Provider Identifier
1093228686
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Mental Health Counselor
- License
- 39001755A
- Practice address
- 4410 Executive Blvd
Fort Wayne, IN 46808-1135 - Phone
- (317) 452-6279
- NPI assigned
- Nov 6, 2017
- Sex
- Female
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | 39001755A | IN | Primary |
Addresses
Primary practice location
4410 Executive Blvd
Fort Wayne, IN 46808-1135
Mailing address
11401 Bluegrass Pkwy
Louisville, KY 40299-2349
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in IN, MI
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: No
- Power mobility devices: No
- Hospice: No
Enrollment records 2
Care Compare profile
Medicare Care Compare- Specialty
- Mental Health Counselor
- Education
- Other, 2002
- Medicare assignment
- May accept Medicare assignment
Practice addresses (Care Compare)
66 E Flagler St
Miami, FL 33130-1807
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 39001755A | IN | MD | Mental Health Counselor |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Grow Healthcare Group PA | Mental Health | Current | Accepting new patients |
Locations
66 W Flagler St
Ste 900
Miami, FL 33130
Phone (786) 244-7711
9465 Counselors Row
Ste 200
Indianapolis, IN 46240
Phone (463) 220-4646
250 Monroe Ave NW
Ste 400
Grand Rapids, MI 49503
Phone (616) 441-4616
Organizations & group practices 1
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": "1509926400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1712620800000",
"number": "1093228686",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "11401 BLUEGRASS PKWY",
"city": "LOUISVILLE",
"state": "KY",
"postal_code": "402992349"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4410 EXECUTIVE BLVD",
"city": "FORT WAYNE",
"state": "IN",
"postal_code": "468081135",
"telephone_number": "317-452-6279"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DARR",
"first_name": "HALEY",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2017-11-06",
"last_updated": "2024-04-09",
"certification_date": "2024-04-09",
"status": "A"
},
"taxonomies": [
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": "IN",
"license": "39001755A",
"primary": true
}
],
"identifiers": [],
"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 Apr 9, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.