Path Forward Therapy

Primary specialty

Social WorkerTaxonomy code 104100000X

Legal business name

PATH FORWARD THERAPY

Practice address

6359 Constitution Dr
Fort Wayne, IN 46804-1547

Phone

(419) 890-5500

Fax

(260) 235-3829

NPI assigned

Oct 15, 2025

Last updated

Oct 15, 2025By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Ms. Taylor R Niese, LSWNPI 1730685512

Title

Owner

Phone

(419) 890-5500

Specialties & licenses 1

Addresses

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Taylor Niese, LSW

  • Social Worker
  • Fort Wayne, IN
  • NPI 1730685512
  NPD Authorized official

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

{
    "created_epoch": "1760486400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1760486400000",
    "number": "1114893229",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6359 CONSTITUTION DR",
            "city": "FORT WAYNE",
            "state": "IN",
            "postal_code": "468041547",
            "telephone_number": "419-890-5500",
            "fax_number": "260-235-3829"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6359 CONSTITUTION DR",
            "city": "FORT WAYNE",
            "state": "IN",
            "postal_code": "468041547",
            "telephone_number": "419-890-5500",
            "fax_number": "260-235-3829"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PATH FORWARD THERAPY",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-10-15",
        "last_updated": "2025-10-15",
        "certification_date": "2025-10-15",
        "status": "A",
        "authorized_official_last_name": "NIESE",
        "authorized_official_first_name": "TAYLOR",
        "authorized_official_middle_name": "R",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "419-890-5500",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "LSW"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Social Worker",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Social Worker in Fort Wayne, IN
• Providers in Fort Wayne, IN by specialty
• Social Worker in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 15, 2025; 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.