Organization Active NPI

David N Lombard, PH.D, LLC

  • Counseling Psychologist
  • Fort Wayne, IN
National Provider Identifier
1497076749
Registry record updated Jun 21, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Counseling PsychologistTaxonomy code 103TC1900X
License
20041481A Issued in IN
Legal business name
DAVID N LOMBARD, PH.D, LLC
Practice address
3242 Mallard Cove LN
Fort Wayne, IN 46804-2883
Phone
(260) 459-2900
Fax
(260) 459-2901
NPI assigned
Jun 21, 2010
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 21, 2010

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

Authorized official

Name
Dr. David N Lombard, PH.DNPI 1891836417
Title
President/Owner
Phone
(260) 459-2900

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Counseling PsychologistGroup: 193400000X SINGLE SPECIALTY GROUP 103TC1900X 20041481A IN Primary

Addresses

Primary practice location

3242 Mallard Cove LN
Fort Wayne, IN 46804-2883

Mailing address

3242 Mallard Cove LN
Fort Wayne, IN 46804-2883
Phone (260) 459-2900

Other identifiers 1

IdentifierTypeStateIssuer
200342760MedicaidIN

National Provider Directory

National Provider Directory

Locations

3242 Mallard Cove Ln
Fort Wayne, IN 46804
Phone (219) 402-1766

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1277078400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1277078400000",
    "number": "1497076749",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3242 MALLARD COVE LN",
            "city": "FORT WAYNE",
            "state": "IN",
            "postal_code": "468042883",
            "telephone_number": "260-459-2900",
            "fax_number": "260-459-2901"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3242 MALLARD COVE LN",
            "city": "FORT WAYNE",
            "state": "IN",
            "postal_code": "468042883",
            "telephone_number": "260-459-2900",
            "fax_number": "260-459-2901"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DAVID N LOMBARD, PH.D, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-06-21",
        "last_updated": "2010-06-21",
        "status": "A",
        "authorized_official_last_name": "LOMBARD",
        "authorized_official_first_name": "DAVID",
        "authorized_official_middle_name": "N",
        "authorized_official_title_or_position": "PRESIDENT/OWNER",
        "authorized_official_telephone_number": "260-459-2900",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PH.D"
    },
    "taxonomies": [
        {
            "code": "103TC1900X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychologist, Counseling",
            "state": "IN",
            "license": "20041481A",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200342760",
            "state": "IN"
        }
    ],
    "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 21, 2010; 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.