Organization Active NPI

Frontline Alchemy Care, LLC

  • Marriage & Family Therapist
  • Fort Wayne, IN
National Provider Identifier
1215767264
Registry record updated Aug 5, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
Legal business name
FRONTLINE ALCHEMY CARE, LLC
Practice address
4646 W Jefferson Blvd Ste 270
Fort Wayne, IN 46804-6832
Phone
(260) 207-4241
NPI assigned
Aug 5, 2024
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 5, 2024

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

Authorized official

Name
Mr. William Elton Roberson III
Title
Owner / Office Manager
Phone
(260) 417-2441

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Marriage & Family TherapistGroup: 193400000X SINGLE SPECIALTY GROUP 106H00000X Primary

Addresses

Primary practice location

4646 W Jefferson Blvd Ste 270
Fort Wayne, IN 46804-6832

Mailing address

4646 W Jefferson Blvd Ste 270
Fort Wayne, IN 46804-6832
Phone (260) 207-4241

National Provider Directory

National Provider Directory

Locations

4646 W Jefferson Blvd
Ste 270
Fort Wayne, IN 46804
Phone (260) 207-4241

Practitioners & affiliated clinicians

Practitioners 1

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

NPI Registry JSON

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

{
    "created_epoch": "1722816000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1722816000000",
    "number": "1215767264",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4646 W JEFFERSON BLVD STE 270",
            "city": "FORT WAYNE",
            "state": "IN",
            "postal_code": "468046832",
            "telephone_number": "260-207-4241"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4646 W JEFFERSON BLVD STE 270",
            "city": "FORT WAYNE",
            "state": "IN",
            "postal_code": "468046832",
            "telephone_number": "260-207-4241"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FRONTLINE ALCHEMY CARE, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-08-05",
        "last_updated": "2024-08-05",
        "certification_date": "2024-08-05",
        "status": "A",
        "authorized_official_last_name": "ROBERSON",
        "authorized_official_first_name": "WILLIAM",
        "authorized_official_middle_name": "ELTON",
        "authorized_official_title_or_position": "OWNER / OFFICE MANAGER",
        "authorized_official_telephone_number": "260-417-2441",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_name_suffix": "III"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Marriage & Family Therapist",
            "state": null,
            "license": null,
            "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 Aug 5, 2024; 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.