Core Dynamics

Primary specialty

Community/Behavioral Health AgencyTaxonomy code 251S00000X

License

39000527A Issued in IN

Legal business name

CORE DYNAMICS

Practice address

10315 Dawsons Creek Blvd Ste E
Fort Wayne, IN 46825-1912

Phone

(260) 387-6340

Fax

(260) 387-6984

NPI assigned

Jan 14, 2015

Last updated

Jan 14, 2015By 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

Nancy Lee Williams, MA, LMHC, BCPPC

Title

Owner

Phone

(260) 417-3051

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1421193600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1421193600000",
    "number": "1437548328",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1590 CARRINGTON WAY",
            "city": "BERNE",
            "state": "IN",
            "postal_code": "467112074",
            "telephone_number": "260-417-3051"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10315 DAWSONS CREEK BLVD STE E",
            "city": "FORT WAYNE",
            "state": "IN",
            "postal_code": "468251912",
            "telephone_number": "260-387-6340",
            "fax_number": "260-387-6984"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CORE DYNAMICS",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-01-14",
        "last_updated": "2015-01-14",
        "status": "A",
        "authorized_official_last_name": "WILLIAMS",
        "authorized_official_first_name": "NANCY",
        "authorized_official_middle_name": "LEE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "260-417-3051",
        "authorized_official_credential": "MA, LMHC, BCPPC"
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": "IN",
            "license": "39000527A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Community/Behavioral Health Agency in Fort Wayne, IN
• Providers in Fort Wayne, IN by specialty
• Community/Behavioral Health Agency in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 14, 2015; 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.