Individual provider Active NPI

Madeleine Mills Teeter, LMHC

  • Mental Health Counselor
  • Fort Wayne, IN
National Provider Identifier
1235925421
Registry record updated Aug 26, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
39005432A Issued in IN
Practice address
909 E State Blvd
Fort Wayne, IN 46805-3404
Phone
(260) 481-2700
Fax
(260) 481-2838
NPI assigned
Apr 16, 2025
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 26, 2025

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 39005432A IN Primary

Addresses

Primary practice location

909 E State Blvd
Fort Wayne, IN 46805-3404

Mailing address

11109 Parkview Plaza Dr # 117
Fort Wayne, IN 46845-1701

Other names 1

  • Madeleine Mills Hjelm Former name

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
I20250515000602 IN Practitioner - Mental Health Counselor 6305364258 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
39005432AINMDMental Health Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Renovate Counseling Services LLC Mental Health CurrentSince Apr 17, 2025 Accepting new patients
Park Center Inc CurrentSince Aug 5, 2025 Accepting new patients
Park Center Inc CurrentSince Aug 5, 2025 Accepting new patients

Locations

105 W Cherry St
Bluffton, IN 46714
Phone (260) 307-5030

11109 Parkview Plaza Dr
#117
Fort Wayne, IN 46845
Phone (260) 266-6012

909 E State Blvd
Fort Wayne, IN 46805
Phone (260) 481-2718

37 E Washington St
Shelbyville, IN 46176
Phone (260) 307-5030

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1744761600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1756166400000",
    "number": "1235925421",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11109 PARKVIEW PLAZA DR # 117",
            "city": "FORT WAYNE",
            "state": "IN",
            "postal_code": "468451701"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "909 E STATE BLVD",
            "city": "FORT WAYNE",
            "state": "IN",
            "postal_code": "468053404",
            "telephone_number": "260-481-2700",
            "fax_number": "260-481-2838"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TEETER",
        "first_name": "MADELEINE",
        "middle_name": "MILLS",
        "credential": "LMHC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-04-16",
        "last_updated": "2025-08-26",
        "certification_date": "2025-08-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "IN",
            "license": "39005432A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MADELEINE",
            "last_name": "HJELM",
            "middle_name": "MILLS",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Fort Wayne, IN

Sources for this page

Verify at the official NPI Registry.