Individual provider Active NPI

Amy L Drake, MSW, LCSW

  • Mental Health Counselor
  • Auburn, IN
National Provider Identifier
1508172180
Registry record updated Dec 28, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
34006389A Issued in IN
Practice address
117 W 9TH St
Auburn, IN 46706-2224
Phone
(260) 925-2017
NPI assigned
Aug 20, 2010
Last updated
Dec 28, 2011By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 28, 2011

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X NU
Mental Health Counselor 101YM0800X 34006389A IN Primary

Addresses

Primary practice location

117 W 9TH St
Auburn, IN 46706-2224

Mailing address

1746 Oakwood Dr
Winona Lake, IN 46590-1665
Phone (574) 453-7454

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
I20120202000542 IN Practitioner - Clinical Social Worker 3779740774 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2007
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Lutheran Social Services of Indiana IncGroup PAC ID 7416344262, 5 clinicians

Practice addresses (Care Compare)

333 E Lewis St
Fort Wayne, IN 46802-3139
Phone (260) 426-3347

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Lutheran Social Services of Indiana Inc. CurrentSince Mar 28, 2022 Accepting new patients
Family Counseling Center, LLC PastSince Sep 5, 2021 Accepting new patients
Von Bargen Associates, Inc. Mental Health Past Accepting new patients
James P. Spink Past Accepting new patients

Locations

333 E Lewis St
Fort Wayne, IN 46802
Phone (260) 426-3347

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": "1282262400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1325030400000",
    "number": "1508172180",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1746 OAKWOOD DR",
            "city": "WINONA LAKE",
            "state": "IN",
            "postal_code": "465901665",
            "telephone_number": "574-453-7454"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "117 W 9TH ST",
            "city": "AUBURN",
            "state": "IN",
            "postal_code": "467062224",
            "telephone_number": "260-925-2017"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DRAKE",
        "first_name": "AMY",
        "middle_name": "L",
        "credential": "MSW, LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-08-20",
        "last_updated": "2011-12-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "IN",
            "license": "34006389A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Auburn, IN

Sources for this page

Verify at the official NPI Registry.