Midwest Addiction Psychiatric & Psychological Services LLC

Primary specialty

Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X

License

14060ASO Issued in IN

Legal business name

MIDWEST ADDICTION PSYCHIATRIC & PSYCHOLOGICAL SERVICES LLC

Doing business as

Mapps

Practice address

3010 E. State Blvd
Ste 100
Fort Wayne, IN 46805

Phone

(260) 471-0632

Fax

(260) 471-3451

NPI assigned

May 15, 2006

Last updated

Mar 2, 2018By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Don A Marshall Jr., M.D.NPI 1144274275

Title

Owner

Phone

(260) 456-7261

Specialties & licenses 11

Addresses

Other identifiers 1

Other names 1

• MAPPS Doing business as

Locations

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Don A Marshall Jr., MD

  • Psychiatry Physician
  • Fort Wayne, IN
  • NPI 1144274275
  Authorized official Same address or phone
• Sandra J Klinker, MSW, ACSW

  • Clinical Social Worker
  • Fort Wayne, IN
  • NPI 1710926225
  NPD (past)
• Mary E Sailer

  • Addiction (Substance Use Disorder) Counselor
  • Fort Wayne, IN
  • NPI 1841243870
  NPD (past)
• Jon Sharpe, MSW,LCSW,ACSW

  • Marriage & Family Therapist
  • Fort Wayne, IN
  • NPI 1982644423

  Clinical

  NPD (past)

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

{
    "created_epoch": "1147651200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1519948800000",
    "number": "1336190149",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3010 E STATE BLVD",
            "address_2": "SUTIE A",
            "city": "FORT WAYNE",
            "state": "IN",
            "postal_code": "468054700",
            "telephone_number": "260-471-0632",
            "fax_number": "260-471-3451"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3010 E. STATE BLVD",
            "address_2": "STE 100",
            "city": "FORT WAYNE",
            "state": "IN",
            "postal_code": "46805",
            "telephone_number": "260-471-0632",
            "fax_number": "260-471-3451"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MIDWEST ADDICTION PSYCHIATRIC & PSYCHOLOGICAL SERVICES LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-15",
        "last_updated": "2018-03-02",
        "status": "A",
        "authorized_official_last_name": "MARSHALL",
        "authorized_official_first_name": "DON",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "260-456-7261",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_name_suffix": "Jr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "IN",
            "license": "14060ASO",
            "primary": true
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "IN",
            "license": "14060ASO",
            "primary": false
        },
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "IN",
            "license": "14060ASO",
            "primary": false
        },
        {
            "code": "103TA0400X",
            "taxonomy_group": "",
            "desc": "Psychologist, Addiction (Substance Use Disorder)",
            "state": "IN",
            "license": "14060ASO",
            "primary": false
        },
        {
            "code": "103TB0200X",
            "taxonomy_group": "",
            "desc": "Psychologist, Cognitive & Behavioral",
            "state": "IN",
            "license": "14060ASO",
            "primary": false
        },
        {
            "code": "103TC2200X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical Child & Adolescent",
            "state": "IN",
            "license": "14060ASO",
            "primary": false
        },
        {
            "code": "103TF0200X",
            "taxonomy_group": "",
            "desc": "Psychologist, Forensic",
            "state": "IN",
            "license": "14060ASO",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "IN",
            "license": "14060ASO",
            "primary": false
        },
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "IN",
            "license": "14060ASO",
            "primary": false
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "IN",
            "license": "14060ASO",
            "primary": false
        },
        {
            "code": "2084P0802X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Addiction Psychiatry",
            "state": "IN",
            "license": "14060ASO",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200200260A",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "MAPPS",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Addiction (Substance Use Disorder) Counselor in Fort Wayne, IN
• Providers in Fort Wayne, IN by specialty
• Addiction (Substance Use Disorder) Counselor in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 2, 2018; 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.