Individual provider Active NPI

Ashlie Straka, LMHCA

  • Mental Health Counselor
  • Fort Wayne, IN
National Provider Identifier
1205374840
Registry record updated Feb 2, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
88000156A Issued in IN
Practice address
6335 Constitution Dr
Fort Wayne, IN 46804-1547
Phone
(260) 436-5353
NPI assigned
Feb 2, 2017
Last updated
Feb 2, 2017By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 2, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X 88000156A IN Primary

Addresses

Primary practice location

6335 Constitution Dr
Fort Wayne, IN 46804-1547

Mailing address

6335 Constitution Dr
Fort Wayne, IN 46804-1547
Phone (260) 436-5353

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
88000156AINMDMental Health Counselor

NPI Registry JSON

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

{
    "created_epoch": "1485993600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1485993600000",
    "number": "1205374840",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6335 CONSTITUTION DR",
            "city": "FORT WAYNE",
            "state": "IN",
            "postal_code": "468041547",
            "telephone_number": "260-436-5353"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6335 CONSTITUTION DR",
            "city": "FORT WAYNE",
            "state": "IN",
            "postal_code": "468041547",
            "telephone_number": "260-436-5353"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STRAKA",
        "first_name": "ASHLIE",
        "name_prefix": "Ms.",
        "credential": "LMHCA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-02-02",
        "last_updated": "2017-02-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "IN",
            "license": "88000156A",
            "primary": true
        }
    ],
    "identifiers": [],
    "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 2, 2017; 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.