NPIMap

Organization Active NPI

Heath Lisenby, LLC

  • Community/Behavioral Health Agency
  • Fort Wayne, IN
National Provider Identifier
1497291900
Registry record updated Jan 9, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Behavioral Health AgencyTaxonomy code 251S00000X
License
39001625A Issued in IN
Legal business name
HEATH LISENBY, LLC
Practice address
6334 Constitution Dr
Fort Wayne, IN 46804-1518
Phone
(260) 443-3355
Fax
(260) 383-0302
NPI assigned
Jan 9, 2017
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 9, 2017

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

Authorized official

Name
Dr. Heath Lisenby, D.MIN.
Title
Owner/Director
Phone
(260) 969-0288

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community/Behavioral Health Agency 251S00000X 39001625A IN Primary

Addresses

Primary practice location

6334 Constitution Dr
Fort Wayne, IN 46804-1518

Mailing address

6334 Constitution Dr
Fort Wayne, IN 46804-1518
Phone (260) 443-3355

Other names 1

  • Lisenby Counseling Doing business as

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1483920000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1483920000000",
    "number": "1497291900",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6334 CONSTITUTION DR",
            "city": "FORT WAYNE",
            "state": "IN",
            "postal_code": "468041518",
            "telephone_number": "260-443-3355",
            "fax_number": "260-383-0302"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6334 CONSTITUTION DR",
            "city": "FORT WAYNE",
            "state": "IN",
            "postal_code": "468041518",
            "telephone_number": "260-443-3355",
            "fax_number": "260-383-0302"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HEATH LISENBY, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-01-09",
        "last_updated": "2017-01-09",
        "status": "A",
        "authorized_official_last_name": "LISENBY",
        "authorized_official_first_name": "HEATH",
        "authorized_official_title_or_position": "OWNER/DIRECTOR",
        "authorized_official_telephone_number": "260-969-0288",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.MIN."
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": "IN",
            "license": "39001625A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Lisenby Counseling",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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 Jan 9, 2017; 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.