Active NPI
James A. Dance, D.MIN.
- Mental Health Counselor
- Fort Wayne, IN
National Provider Identifier
1275679391
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Mental Health Counselor
- License
- 39000394A
- Practice address
- 300 W Wayne St
Fort Wayne, IN 46802-3608 - Phone
- (260) 422-8556
- Fax
- (260) 422-8558
- NPI assigned
- Jan 29, 2007
- Last updated
- May 14, 2008
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | 39000394A | IN | Primary |
Addresses
Primary practice location
300 W Wayne St
Fort Wayne, IN 46802-3608
Mailing address
6612 Tralee CT
Fort Wayne, IN 46835-9662
Phone (260) 486-1089
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 00055 | Other | IN | ICAC-II |
| 39000394A | Other | IN | MENTAL HEALTH LICENSE |
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
| License | State | Type | Specialty |
|---|---|---|---|
| 39000394A | IN | MD | Mental Health Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1170028800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1210723200000",
"number": "1275679391",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "6612 TRALEE CT",
"city": "FORT WAYNE",
"state": "IN",
"postal_code": "468359662",
"telephone_number": "260-486-1089"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "300 W WAYNE ST",
"city": "FORT WAYNE",
"state": "IN",
"postal_code": "468023608",
"telephone_number": "260-422-8556",
"fax_number": "260-422-8558"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DANCE",
"first_name": "JAMES",
"middle_name": "A.",
"name_prefix": "Dr.",
"credential": "D.MIN.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2007-01-29",
"last_updated": "2008-05-14",
"status": "A"
},
"taxonomies": [
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": "IN",
"license": "39000394A",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "ICAC-II",
"identifier": "00055",
"state": "IN"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MENTAL HEALTH LICENSE",
"identifier": "39000394A",
"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 May 14, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.