Active NPI
Carl Wayne Sovine, PHD
- Marriage & Family Therapist
- Ft Wayne, IN
National Provider Identifier
1326226366
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Marriage & Family Therapist
- License
- 35001103
- Practice address
- 5736 Coventry LN
Ft Wayne, IN 46804 - Phone
- (260) 436-4119
- NPI assigned
- Feb 1, 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 |
|---|---|---|---|---|
| Marriage & Family Therapist | 106H00000X | 35001103 | IN | Primary |
Addresses
Primary practice location
5736 Coventry LN
Ft Wayne, IN 46804
Mailing address
5736 Coventry LN
Ft Wayne, IN 46804
Phone (260) 436-4119
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
- Credentials
- Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 35001103 | IN | MD | Marriage & Family Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1201824000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1201824000000",
"number": "1326226366",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5736 COVENTRY LN",
"city": "FT WAYNE",
"state": "IN",
"postal_code": "46804",
"telephone_number": "260-436-4119"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5736 COVENTRY LN",
"city": "FT WAYNE",
"state": "IN",
"postal_code": "46804",
"telephone_number": "260-436-4119"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SOVINE",
"first_name": "CARL",
"middle_name": "WAYNE",
"name_prefix": "Dr.",
"credential": "PHD",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2008-02-01",
"last_updated": "2008-02-01",
"status": "A"
},
"taxonomies": [
{
"code": "106H00000X",
"taxonomy_group": "",
"desc": "Marriage & Family Therapist",
"state": "IN",
"license": "35001103",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Ft Wayne, IN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 1, 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.