Kathryn Valentic

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

39003643A Issued in IN

Practice address

310 E Dupont Rd
Fort Wayne, IN 46825-8000

Phone

(260) 222-1572

Fax

(260) 846-2389

NPI assigned

Jun 6, 2022

Last updated

Jun 6, 2022By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1654473600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1654473600000",
    "number": "1093444143",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "310 E DUPONT RD",
            "city": "FORT WAYNE",
            "state": "IN",
            "postal_code": "468258000",
            "telephone_number": "260-222-1572",
            "fax_number": "260-846-2389"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "310 E DUPONT RD",
            "city": "FORT WAYNE",
            "state": "IN",
            "postal_code": "468258000",
            "telephone_number": "260-222-1572",
            "fax_number": "260-846-2389"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VALENTIC",
        "first_name": "KATHRYN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-06-06",
        "last_updated": "2022-06-06",
        "certification_date": "2022-06-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "IN",
            "license": "39003643A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "www.fortwaynerecovery.com",
            "affiliation": "N",
            "endpointDescription": "website",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "contact admission",
            "address_1": "310 E DuPont Rd",
            "city": "Fort Wayne",
            "state": "IN",
            "country_code": "US",
            "postal_code": "468258000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• VA Northern Indiana Health Care System
• Christopher M Vachon
• Mekenzie L Vachon, RBT
• Michael S Valade, M.D.
• Maria Regina Valcarcel, MD
• Valerie E Lake, DDS, LLC
• Brenda M Valliere, DDS
• Jeffrey Paul Valliere, DDS
• Roger Paul Valliere, D.D.S.
• Adele Vallow

• Mental Health Counselor in Fort Wayne, IN
• Providers in Fort Wayne, IN by specialty
• Mental Health Counselor in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 6, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.