Active NPI
Megan Fishback
- Marriage & Family Therapist
- Indianapolis, IN
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Marriage & Family Therapist
- License
- 35002435A
- Practice address
- 8401 Harcourt Rd
Indianapolis, IN 46260-2036 - Phone
- (317) 338-4600
- NPI assigned
- Sep 20, 2021
- Last updated
- Nov 20, 2024
- Sex
- Female
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Marriage & Family Therapist | 106H00000X | 148645 | CA | |
| Marriage & Family Therapist | 106H00000X | 35002435A | IN | Primary |
Addresses
Primary practice location
8401 Harcourt Rd
Indianapolis, IN 46260-2036
Mailing address
8401 Harcourt Rd
Indianapolis, IN 46260-2036
Other practice location 1
12099 W Washington Blvd
Los Angeles, CA 90066-5882
Phone (818) 267-2681
Other practice location 2
350 Monon Blvd Apt 151
Carmel, IN 46032-2357
Phone (650) 995-3424
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
Enrollment records 1
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 148645 | CA | MD | Marriage & Family Therapist |
| 35002435A | IN | MD | Marriage & Family Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| St. Vincent Hospital & Health Care Center, Inc. | Current | Accepting new patients | |
| St. Vincent Hospital & Health Care Center, Inc. | Marriage & Family Therapist | Current | Accepting new patients |
Locations
250 W 96th St
Ste 520
Indianapolis, IN 46260
Phone (317) 583-3211
8401 Harcourt Rd
Indianapolis, IN 46260
Phone (317) 338-4600
8401 Harcourt Rd
Ste 302
Indianapolis, IN 46260
Phone (317) 338-4600
Organizations & group practices 2
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.
-
dba Ascension St. Vincent Stress Center
- Psychiatry Physician
- Indianapolis, IN
- NPI 1689869893
Marriage & Family Therapist
-
dba Ascension St. Vincent Pharmacy
- Community/Retail Pharmacy
- Indianapolis, IN
- NPI 1194929646
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1632096000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1732060800000",
"number": "1134899271",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "8401 HARCOURT RD",
"city": "INDIANAPOLIS",
"state": "IN",
"postal_code": "462602036"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "8401 HARCOURT RD",
"city": "INDIANAPOLIS",
"state": "IN",
"postal_code": "462602036",
"telephone_number": "317-338-4600"
}
],
"practiceLocations": [
{
"address_1": "12099 W Washington Blvd",
"address_purpose": "LOCATION",
"city": "Los Angeles",
"state": "CA",
"postal_code": "900665882",
"country_code": "US",
"telephone_number": "818-267-2681",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "350 Monon Blvd Apt 151",
"address_purpose": "LOCATION",
"city": "Carmel",
"state": "IN",
"postal_code": "460322357",
"country_code": "US",
"telephone_number": "650-995-3424",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "FISHBACK",
"first_name": "MEGAN",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2021-09-20",
"last_updated": "2024-11-20",
"certification_date": "2024-11-20",
"status": "A"
},
"taxonomies": [
{
"code": "106H00000X",
"taxonomy_group": "",
"desc": "Marriage & Family Therapist",
"state": "CA",
"license": "148645",
"primary": false
},
{
"code": "106H00000X",
"taxonomy_group": "",
"desc": "Marriage & Family Therapist",
"state": "IN",
"license": "35002435A",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Indianapolis, IN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 20, 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.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.