Active NPI
Kaley Soule
- Mental Health Counselor
- Fort Wayne, IN
National Provider Identifier
1447092531
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Mental Health Counselor
- License
- 88001989A
- Practice address
- 4150 Illinois Rd
Fort Wayne, IN 46804-1208 - Phone
- (260) 240-4945
- NPI assigned
- Jun 10, 2024
- Sex
- Female
- Sole proprietor
- No
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 | 88001989A | IN | Primary |
Addresses
Primary practice location
4150 Illinois Rd
Fort Wayne, IN 46804-1208
Mailing address
3528 Bass Rd
Fort Wayne, IN 46808-2929
Phone (517) 745-7071
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: No
- Power mobility devices: No
- Hospice: No
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 88001989A | IN | MD | Mental Health Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1717977600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1717977600000",
"number": "1447092531",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3528 BASS RD",
"city": "FORT WAYNE",
"state": "IN",
"postal_code": "468082929",
"telephone_number": "517-745-7071"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4150 ILLINOIS RD",
"city": "FORT WAYNE",
"state": "IN",
"postal_code": "468041208",
"telephone_number": "260-240-4945"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SOULE",
"first_name": "KALEY",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2024-06-10",
"last_updated": "2024-06-10",
"certification_date": "2024-06-10",
"status": "A"
},
"taxonomies": [
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": "IN",
"license": "88001989A",
"primary": true
}
],
"identifiers": [],
"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 Jun 10, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.