Individual provider Active NPI

Karah Wynn, MSW, LCSW, PMH-C

  • Clinical Social Worker
  • Fort Wayne, IN
National Provider Identifier
1174180939
Registry record updated Jul 28, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
34008691A Issued in IN
Practice address
6131 Stoney Creek Dr
Fort Wayne, IN 46825-4408
Phone
(260) 209-4461
NPI assigned
May 28, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 28, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 33008369A IN
Clinical Social Worker 1041C0700X 34008691A IN Primary

Addresses

Primary practice location

6131 Stoney Creek Dr
Fort Wayne, IN 46825-4408

Mailing address

6131 Stoney Creek Dr
Fort Wayne, IN 46825-4408
Phone (260) 573-4822

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
I20230912001633 IN Practitioner - Clinical Social Worker 4082078936 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
33008369AINMDClinical Social Worker
34008691AINMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Cook Behavioral Health Clinic, PC CurrentSince Sep 1, 2023 Accepting new patients
Rooted in Healing Clinical Current Accepting new patients
Viking Psychiatry LLC PastSince Oct 29, 2023 Accepting new patients
Crossroad Child & Family Services, Inc. PastSince Feb 18, 2024 Accepting new patients
Crossroad - Fort Wayne Childrens Home Past Accepting new patients

Locations

347 W Berry St
Ste 200
Fort Wayne, IN 46802
Phone (260) 483-2400

6131 Stoney Creek Dr
Fort Wayne, IN 46825
Phone (260) 209-4461

7230 Engle Rd
Ste 304
Fort Wayne, IN 46804
Phone (260) 344-4146

Organizations & group practices 5

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": "1559001600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1753660800000",
    "number": "1174180939",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6131 STONEY CREEK DR",
            "city": "FORT WAYNE",
            "state": "IN",
            "postal_code": "468254408",
            "telephone_number": "260-573-4822"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6131 STONEY CREEK DR",
            "city": "FORT WAYNE",
            "state": "IN",
            "postal_code": "468254408",
            "telephone_number": "260-209-4461"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WYNN",
        "first_name": "KARAH",
        "credential": "MSW, LCSW, PMH-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-05-28",
        "last_updated": "2025-07-28",
        "certification_date": "2025-07-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "IN",
            "license": "33008369A",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "IN",
            "license": "34008691A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Wayne, IN

Sources for this page

Verify at the official NPI Registry.