NPIMap

Organization Active NPI

Brenda Stoops Counseling, LLC

  • Mental Health Counselor
  • Fort Wayne, IN
National Provider Identifier
1164572913
Registry record updated Aug 8, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
39001280A Issued in IN
Legal business name
BRENDA STOOPS COUNSELING, LLC
Practice address
10305 Dawsons Creek Blvd
Suite C
Fort Wayne, IN 46825-1914
Phone
(260) 416-0600
Fax
(260) 416-0601
NPI assigned
Jan 12, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 8, 2008

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

Authorized official

Name
Mrs. Brenda Kay Lee Stoops, LMHC
Title
Owner
Phone
(260) 416-0600

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health CounselorGroup: 193400000X SINGLE SPECIALTY GROUP 101YM0800X 39001280A IN Primary

Addresses

Primary practice location

10305 Dawsons Creek Blvd
Suite C
Fort Wayne, IN 46825-1914

Mailing address

10305 Dawsons Creek Blvd
Suite C
Fort Wayne, IN 46825-1914
Phone (260) 416-0600

Other identifiers 1

IdentifierTypeStateIssuer
200447760MedicaidIN

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1168560000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1218153600000",
    "number": "1164572913",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10305 DAWSONS CREEK BLVD",
            "address_2": "SUITE C",
            "city": "FORT WAYNE",
            "state": "IN",
            "postal_code": "468251914",
            "telephone_number": "260-416-0600",
            "fax_number": "260-416-0601"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10305 DAWSONS CREEK BLVD",
            "address_2": "SUITE C",
            "city": "FORT WAYNE",
            "state": "IN",
            "postal_code": "468251914",
            "telephone_number": "260-416-0600",
            "fax_number": "260-416-0601"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BRENDA STOOPS COUNSELING, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-12",
        "last_updated": "2008-08-08",
        "status": "A",
        "authorized_official_last_name": "STOOPS",
        "authorized_official_first_name": "BRENDA",
        "authorized_official_middle_name": "KAY LEE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "260-416-0600",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "LMHC"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Counselor, Mental Health",
            "state": "IN",
            "license": "39001280A",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200447760",
            "state": "IN"
        }
    ],
    "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 Aug 8, 2008; 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.