Individual provider Active NPI

Tina Marie Parker, LMFT

  • Marriage & Family Therapist
  • Fort Wayne, IN
National Provider Identifier
1104482678
Registry record updated Jan 24, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
License
35002150A Issued in IN
Practice address
12948 Coldwater Rd Ste 101
Fort Wayne, IN 46845-8016
Phone
(260) 373-0880
Fax
(260) 373-0881
NPI assigned
May 10, 2019
Last updated
Jan 24, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 24, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X NU
Marriage & Family Therapist 106H00000X 35002150A IN Primary

Addresses

Primary practice location

12948 Coldwater Rd Ste 101
Fort Wayne, IN 46845-8016

Mailing address

3894 New Vision Dr
Fort Wayne, IN 46845-1708
Phone (260) 373-0880

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
I20231122000917 IN Practitioner - Marriage and Family Therapist 9032567565 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Marriage and Family Therapist
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Aberdeen Group LLCGroup PAC ID 5597922757, 12 clinicians

Practice addresses (Care Compare)

12948 Coldwater Rd
Suite 101
Fort Wayne, IN 46845-8016
Phone (260) 373-0880

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Aberdeen Group LLC CurrentSince Jan 1, 2024 Accepting new patients
Three Rivers Therapy LLC Marriage & Family Therapist CurrentSince May 3, 2026 Accepting new patients
Aberdeen Group LLC CurrentSince Jan 29, 2023 Accepting new patients

Locations

12948 Coldwater Rd
Ste 101
Fort Wayne, IN 46845
Phone (260) 373-0880

3894 New Vision Dr
Fort Wayne, IN 46845
Phone (260) 373-0880

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1557446400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1674518400000",
    "number": "1104482678",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3894 NEW VISION DR",
            "city": "FORT WAYNE",
            "state": "IN",
            "postal_code": "468451708",
            "telephone_number": "260-373-0880",
            "fax_number": "260-373-0881"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12948 COLDWATER RD STE 101",
            "city": "FORT WAYNE",
            "state": "IN",
            "postal_code": "468458016",
            "telephone_number": "260-373-0880",
            "fax_number": "260-373-0881"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PARKER",
        "first_name": "TINA",
        "middle_name": "MARIE",
        "credential": "LMFT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-05-10",
        "last_updated": "2023-01-24",
        "certification_date": "2023-01-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "IN",
            "license": "35002150A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Wayne, IN

Sources for this page

Verify at the official NPI Registry.