Vision Counseling and Psychological Services, PC
Organization Active NPI Psychologist · Fort Wayne, IN
NPI 1609059146 · NPPES record last updated Jul 21, 2022
Key facts
- NPI
- 1609059146
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Psychologist 103T00000X
- Legal business name
- VISION COUNSELING AND PSYCHOLOGICAL SERVICES, PC
- Practice address
- 10315 Dawsons Creek Blvd Ste E
Fort Wayne, IN 46825-1912 - Phone
- (260) 387-6340
- Fax
- (260) 387-6984
- NPI assigned
- Dec 6, 2007
- Organization subpart
- No
Authorized official
- Name
- Dr. Gregory Scott Sowles, HSPP LMHC PHD
- Title
- Psychologist /President
- Phone
- (260) 387-6340
Practitioners 10
-
Gregory Scott Sowles, HSPP LMHC PHD
-
Mary Lisa Barta, MS, LMFTA
-
Rebecca Sue Berghorn, LMFT
-
Kim Maxwell Fish, LCSW, LMHC
-
Victoria Anne Lightcap, MS, LMFTA
-
Jennifer Renee Mertz-Turner, LMHC, MAC
-
Sharon S Miley, LMFT
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in IN
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20081113000696 | IN | Part B Supplier - Clinic/Group Practice | 5799845236 |
Receives reassigned benefits from 1 practitioner Practice locations: Fort Wayne, IN |
National Provider Directory
Locations
10315 Dawsons Creek Blvd
Fort Wayne, IN 46825
Phone 2603876340 ext. 103
229 S State St
Kendallville, IN 46755
Phone (260) 387-6340
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychologist |
103T00000X | Yes |
Addresses
Primary practice location
10315 Dawsons Creek Blvd Ste E
Fort Wayne, IN 46825-1912
Mailing address
10315 Dawsons Creek Blvd Ste E
Fort Wayne, IN 46825-1912
Phone (260) 387-6340
Other names
- Vision Counseling and Psychological Services
Other providers in Fort Wayne, IN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 21, 2022. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.