Providence Counseling Center, Inc.

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

34004602A Issued in IN

Legal business name

PROVIDENCE COUNSELING CENTER, INC.

Practice address

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

Phone

(260) 418-6765

Fax

(260) 416-0601

NPI assigned

Oct 4, 2006

Organization subpart

No

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

Authorized official

Name

Ms. C Laudia D Davis, MSW, LCSW

Title

President/Ceo

Phone

(260) 418-6765

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1159920000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1174619654",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 5622",
            "city": "FORT WAYNE",
            "state": "IN",
            "postal_code": "468955622",
            "telephone_number": "260-418-6765",
            "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": "260-418-6765",
            "fax_number": "260-416-0601"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PROVIDENCE COUNSELING CENTER, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-04",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "DAVIS",
        "authorized_official_first_name": "C LAUDIA",
        "authorized_official_middle_name": "D",
        "authorized_official_title_or_position": "PRESIDENT/CEO",
        "authorized_official_telephone_number": "260-418-6765",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "MSW, LCSW"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Social Worker, Clinical",
            "state": "IN",
            "license": "34004602A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Roman Prosniak, M.D.
• Sizhu Prosniak, A.P.N
• Prosper Holistic Dentistry LLC
• Protailored Physical Therapy LLC
• Alan Prouty, DDS
• Kara Prows
• Jessica Shaye Proxmire
• Robert Alan Pruett III, AGACNP-BC
• Bethany Pruitt, MSW, LCSW
• Zabrina Przybilla, MSED

• Clinical Social Worker in Fort Wayne, IN
• Providers in Fort Wayne, IN by specialty
• Clinical Social Worker in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.