Melinda Tiburcio

Primary specialty

CounselorTaxonomy code 101Y00000X

License

39003502A Issued in IN

Practice address

8211 W Jefferson Blvd Ste 302
Fort Wayne, IN 46804-4796

Phone

(877) 594-9204

NPI assigned

Oct 12, 2021

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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.

• Mindy Tiburcio LLC

  • Counselor
  • Fort Wayne, IN
  • NPI 1346111655
  NPD Authorized official

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

{
    "created_epoch": "1633996800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1633996800000",
    "number": "1144982653",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3619 HARRIS RD",
            "city": "FORT WAYNE",
            "state": "IN",
            "postal_code": "468081450"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8211 W JEFFERSON BLVD STE 302",
            "city": "FORT WAYNE",
            "state": "IN",
            "postal_code": "468044796",
            "telephone_number": "877-594-9204"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TIBURCIO",
        "first_name": "MELINDA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-10-12",
        "last_updated": "2021-10-12",
        "certification_date": "2021-10-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": "IN",
            "license": "39003502A",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CAQH",
            "identifier": "14015842",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Lynette M Thuma, MD
• Udaykanth Thumma
• Craig Thurber
• Amanda Thurston, MS, RD, CD, CDE
• Corey Tibbs
• Sonya Tichler, PTA
• Stewart Gregory Tidwell, MA, LMHC
• Jonathan Alvin Tiedeman, SCHOOL PSYCHOLOGIST
• Susan Marie Tielker-Sharpe, LCSW LMFT ACSW
• Richard Elmer Tielker, M.D.

• Counselor in Fort Wayne, IN
• Providers in Fort Wayne, IN by specialty
• Counselor in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 12, 2021; 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.