Individual provider Active NPI

Nicholas Ray Brauchler, MS

  • Mental Health Counselor
  • Fort Wayne, IN
National Provider Identifier
1144820192
Registry record updated Oct 29, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
Practice address
2100 Goshen Rd
Fort Wayne, IN 46808-1493
Phone
(260) 471-3500
NPI assigned
Oct 29, 2020
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 29, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X Primary

Addresses

Primary practice location

2100 Goshen Rd
Fort Wayne, IN 46808-1493

Mailing address

2621 E Jefferson St
Warsaw, IN 46580-3880

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
I20240125004182 IN Practitioner - Mental Health Counselor 5597118505 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Science

Practice roles

OrganizationSpecialtyStatusNew patients
Alliance Health Centers Inc. CurrentSince Nov 13, 2025 Accepting new patients
Bowen Health Inc CurrentSince Jan 1, 2024 Accepting new patients
Alliance Health Centers, Inc. CurrentSince Nov 13, 2025 Accepting new patients
Bowen Health Inc Current Accepting new patients

Locations

2700 Lafayette St
Ste 110
Fort Wayne, IN 46806
Phone (260) 660-0780

2100 Goshen Rd
Fort Wayne, IN 46808
Phone (260) 471-3500

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.

NPI Registry JSON

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

{
    "created_epoch": "1603929600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1603929600000",
    "number": "1144820192",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2621 E JEFFERSON ST",
            "city": "WARSAW",
            "state": "IN",
            "postal_code": "465803880"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2100 GOSHEN RD",
            "city": "FORT WAYNE",
            "state": "IN",
            "postal_code": "468081493",
            "telephone_number": "260-471-3500"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRAUCHLER",
        "first_name": "NICHOLAS",
        "middle_name": "RAY",
        "credential": "MS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-10-29",
        "last_updated": "2020-10-29",
        "certification_date": "2020-10-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Wayne, IN

Sources for this page

Verify at the official NPI Registry.