Active NPI
Peggy Sue Underwood
- Mental Health Counselor
- Warsaw, IN
National Provider Identifier
1467073585
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Mental Health Counselor
- Practice address
- 105 Enterprise Dr
Warsaw, IN 46580-1204 - Phone
- (574) 268-0448
- NPI assigned
- Apr 29, 2020
- 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 | Primary |
Addresses
Primary practice location
105 Enterprise Dr
Warsaw, IN 46580-1204
Mailing address
6202 Constitution Dr Ste D
Fort Wayne, IN 46804-1583
Phone (260) 432-0066
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
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Lifeworks Counseling & Consulting, Inc. | Current | Accepting new patients |
Locations
6202 Constitution Dr
Ste D
Fort Wayne, IN 46804
Phone (260) 432-0066
105 Enterprise Dr
Warsaw, IN 46580
Phone (574) 268-0448
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
- Professional Counselor
- Fort Wayne, IN
- NPI 1184886541
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1588118400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1588118400000",
"number": "1467073585",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "6202 CONSTITUTION DR STE D",
"city": "FORT WAYNE",
"state": "IN",
"postal_code": "468041583",
"telephone_number": "260-432-0066"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "105 ENTERPRISE DR",
"city": "WARSAW",
"state": "IN",
"postal_code": "465801204",
"telephone_number": "574-268-0448"
}
],
"practiceLocations": [],
"basic": {
"last_name": "UNDERWOOD",
"first_name": "PEGGY",
"middle_name": "SUE",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2020-04-29",
"last_updated": "2020-04-29",
"certification_date": "2020-04-29",
"status": "A"
},
"taxonomies": [
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Warsaw, IN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 29, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.