Individual provider Active NPI

Megan Fishback

  • Marriage & Family Therapist
  • Indianapolis, IN
National Provider Identifier
1134899271
Registry record updated Nov 20, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
License
35002435A Issued in IN
Practice address
8401 Harcourt Rd
Indianapolis, IN 46260-2036
Phone
(317) 338-4600
NPI assigned
Sep 20, 2021
Last updated
Nov 20, 2024By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 20, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
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
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20241207000335 IN Practitioner - Marriage and Family Therapist 1153857677 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
148645CAMDMarriage & Family Therapist
35002435AINMDMarriage & Family Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
St. Vincent Hospital & Health Care Center, Inc. CurrentSince Nov 10, 2024 Accepting new patients
St. Vincent Hospital & Health Care Center, Inc. Marriage & Family Therapist CurrentSince Nov 10, 2024 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.

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

Verify at the official NPI Registry.