Individual provider Active NPI

Vanessa Michelle Hogan, LMHC, LCAC

  • Mental Health Counselor
  • Fort Wayne, IN
National Provider Identifier
1508087842
Registry record updated Jan 26, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
39002066A Issued in IN
Practice address
2622 Lake Ave Ste 1
Fort Wayne, IN 46805-5410
Phone
(260) 299-3160
Fax
(260) 299-3159
NPI assigned
May 2, 2007
Last updated
Jan 26, 2026By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 26, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) Counselor 101YA0400X 87001074A IN
Mental Health Counselor 101YM0800X 39002066A IN Primary

Addresses

Primary practice location

2622 Lake Ave Ste 1
Fort Wayne, IN 46805-5410

Mailing address

240 N Tillotson Ave
Muncie, IN 47304-3988
Phone (765) 288-1928

Other identifiers 1

IdentifierTypeStateIssuer
39002066AOtherININDIANA PROFESSIONAL LICENSING AGENCY

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IN
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20231127000828 IN Practitioner - Mental Health Counselor 7517315948 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
87001074AINMDAddiction (Substance Use Disorder) Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Bowen Health Inc CurrentSince Jul 1, 2024 Accepting new patients
Meridian Health Services Corp. CurrentSince Dec 24, 2025 Accepting new patients
Bowen Health Inc Current Accepting new patients
Meridian Health Services Corp CurrentSince Dec 24, 2025 Accepting new patients

Locations

2622 Lake Ave
Ste 1
Fort Wayne, IN 46805
Phone (260) 299-3160

836 N Detroit St
Lagrange, IN 46761
Phone (260) 499-3019

240 N Tillotson Ave
Muncie, IN 47304

2621 E Jefferson St
Warsaw, IN 46580
Phone (574) 269-0573

850 N Harrison St
Warsaw, IN 46580
Phone (219) 267-7169

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1178064000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1769385600000",
    "number": "1508087842",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "240 N TILLOTSON AVE",
            "city": "MUNCIE",
            "state": "IN",
            "postal_code": "473043988",
            "telephone_number": "765-288-1928",
            "fax_number": "765-741-0335"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2622 LAKE AVE STE 1",
            "city": "FORT WAYNE",
            "state": "IN",
            "postal_code": "468055410",
            "telephone_number": "260-299-3160",
            "fax_number": "260-299-3159"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HOGAN",
        "first_name": "VANESSA",
        "middle_name": "MICHELLE",
        "name_prefix": "Miss",
        "credential": "LMHC, LCAC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-05-02",
        "last_updated": "2026-01-26",
        "certification_date": "2026-01-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "IN",
            "license": "87001074A",
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "IN",
            "license": "39002066A",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "INDIANA PROFESSIONAL LICENSING AGENCY",
            "identifier": "39002066A",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Wayne, IN

Sources for this page

Verify at the official NPI Registry.