NPIMap

Organization Active NPI

Lifeworks Counseling & Consulting, Inc.

  • Professional Counselor
  • Fort Wayne, IN
National Provider Identifier
1184886541
Registry record updated Feb 12, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
39001451 Issued in IN
Legal business name
LIFEWORKS COUNSELING & CONSULTING, INC.
Practice address
6202 Constitution Dr Ste D
Fort Wayne, IN 46804-1583
Phone
(260) 432-0066
Fax
(260) 432-8503
NPI assigned
Jun 27, 2008
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 12, 2024

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

Authorized official

Name
Amy Jo Aldrich, LMFTNPI 1598981649
Title
Owner
Phone
(260) 432-0066

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Professional CounselorGroup: 193400000X SINGLE SPECIALTY GROUP 101YP2500X 39001451 IN Primary

Addresses

Primary practice location

6202 Constitution Dr Ste D
Fort Wayne, IN 46804-1583

Mailing address

6202 Constitution Dr Ste D
Fort Wayne, IN 46804-1583
Phone (260) 432-0066

Other practice location 1

105 Enterprise Dr
Warsaw, IN 46580-1204
Phone (574) 268-0448

Other practice location 2

1601 I St
LA Porte, IN 46350-5772
Phone (574) 268-0448

Other practice location 3

1200 W DePoy Dr
Columbia City, IN 46725-8459
Phone (260) 432-0066

Other practice location 4

2201 N Wayne St
Angola, IN 46703-9108
Phone (260) 432-0066

Other identifiers 1

IdentifierTypeStateIssuer
200912670AMedicaidIN

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IN

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20090608000291 IN Part B Supplier - Clinic/Group Practice 6204986573 Receives reassigned benefits from 10 practitioners
Practice locations: Warsaw, IN; Fort Wayne, IN

National Provider Directory

National Provider Directory

Locations

2201 N Wayne St
Angola, IN 46703
Phone (260) 432-0066

1200 W Depoy Dr
Columbia City, IN 46725
Phone (260) 432-0066

6202 Constitution Dr
Ste D
Fort Wayne, IN 46804
Phone (260) 432-0066

1601 I St
La Porte, IN 46350
Phone (574) 268-0448

105 Enterprise Dr
Warsaw, IN 46580
Phone (574) 268-0448

Practitioners & affiliated clinicians

Practitioners 34

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

View all 34

NPI Registry JSON

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

{
    "created_epoch": "1214524800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1707696000000",
    "number": "1184886541",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6202 CONSTITUTION DR STE D",
            "city": "FORT WAYNE",
            "state": "IN",
            "postal_code": "468041583",
            "telephone_number": "260-432-0066",
            "fax_number": "260-432-8503"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6202 CONSTITUTION DR STE D",
            "city": "FORT WAYNE",
            "state": "IN",
            "postal_code": "468041583",
            "telephone_number": "260-432-0066",
            "fax_number": "260-432-8503"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "105 Enterprise Dr",
            "address_purpose": "LOCATION",
            "city": "Warsaw",
            "state": "IN",
            "postal_code": "465801204",
            "country_code": "US",
            "telephone_number": "574-268-0448",
            "fax_number": "574-549-9039",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1601 I St",
            "address_purpose": "LOCATION",
            "city": "LA Porte",
            "state": "IN",
            "postal_code": "463505772",
            "country_code": "US",
            "telephone_number": "574-268-0448",
            "fax_number": "574-549-9039",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1200 W DePoy Dr",
            "address_purpose": "LOCATION",
            "city": "Columbia City",
            "state": "IN",
            "postal_code": "467258459",
            "country_code": "US",
            "telephone_number": "260-432-0066",
            "fax_number": "260-432-8503",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2201 N Wayne St",
            "address_purpose": "LOCATION",
            "city": "Angola",
            "state": "IN",
            "postal_code": "467039108",
            "country_code": "US",
            "telephone_number": "260-432-0066",
            "fax_number": "260-432-8503",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "LIFEWORKS COUNSELING & CONSULTING, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-06-27",
        "last_updated": "2024-02-12",
        "certification_date": "2024-02-12",
        "status": "A",
        "authorized_official_last_name": "ALDRICH",
        "authorized_official_first_name": "AMY",
        "authorized_official_middle_name": "JO",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "260-432-0066",
        "authorized_official_credential": "LMFT"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Counselor, Professional",
            "state": "IN",
            "license": "39001451",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200912670A",
            "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 Feb 12, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.