Active NPI
Dionne C Couchman, LMFT LCAC
- Marriage & Family Therapist
- Fort Wayne, IN
National Provider Identifier
1134496326
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Marriage & Family Therapist
- License
- 35001800A
- Practice address
- 2200 Randallia Dr
Fort Wayne, IN 46805-4638 - Phone
- (260) 373-8000
- Fax
- (260) 373-8034
- NPI assigned
- Nov 16, 2011
- 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 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Addiction (Substance Use Disorder) Counselor | 101YA0400X | 87000451A | IN | |
| Marriage & Family Therapist | 106H00000X | 35001800A | IN | Primary |
Addresses
Primary practice location
2200 Randallia Dr
Fort Wayne, IN 46805-4638
Mailing address
11109 Parkview Plaza Dr # 117
Fort Wayne, IN 46845-1701
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: No
- Medical equipment: Yes
- Home health: No
- Power mobility devices: No
- Hospice: No
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 87000451A | IN | MD | Addiction (Substance Use Disorder) Counselor |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Bowen Health Inc | Current | Accepting new patients | |
| Bowen Health Inc | Current | Accepting new patients | |
| James P. Spink | Past | Accepting new patients | |
| Family Counseling Center, LLC | Past | Accepting new patients |
Locations
200 Hoosier Dr
Ste E
Angola, IN 46703
Phone (260) 624-3741
850 N Harrison St
Warsaw, IN 46580
Phone (219) 267-7169
2621 E Jefferson St
Warsaw, IN 46580
Phone (574) 269-0573
Organizations & group practices 4
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.
-
- Federally Qualified Health Center (FQHC)
- Fort Wayne, IN
- NPI 1023668183
-
- Adult Mental Health Clinic/Center
- Warsaw, IN
- NPI 1639172810
-
- Clinical Psychologist
- Fort Wayne, IN
- NPI 1730480211
-
- Psychologist
- Auburn, IN
- NPI 1932246972
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1321401600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1620172800000",
"number": "1134496326",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "11109 PARKVIEW PLAZA DR # 117",
"city": "FORT WAYNE",
"state": "IN",
"postal_code": "468451701"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2200 RANDALLIA DR",
"city": "FORT WAYNE",
"state": "IN",
"postal_code": "468054638",
"telephone_number": "260-373-8000",
"fax_number": "260-373-8034"
}
],
"practiceLocations": [],
"basic": {
"last_name": "COUCHMAN",
"first_name": "DIONNE",
"middle_name": "C",
"credential": "LMFT LCAC",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2011-11-16",
"last_updated": "2021-05-05",
"certification_date": "2021-05-05",
"status": "A"
},
"taxonomies": [
{
"code": "101YA0400X",
"taxonomy_group": "",
"desc": "Counselor, Addiction (Substance Use Disorder)",
"state": "IN",
"license": "87000451A",
"primary": false
},
{
"code": "106H00000X",
"taxonomy_group": "",
"desc": "Marriage & Family Therapist",
"state": "IN",
"license": "35001800A",
"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 May 5, 2021; 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.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.