Individual provider Active NPI

Stefani M Tountzios

  • Clinical Social Worker
  • Fort Wayne, IN
National Provider Identifier
1609657642
Registry record updated Sep 11, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
34012606A Issued in IN
Practice address
5920 Decatur Rd
Fort Wayne, IN 46816-3640
Phone
(260) 424-4908
NPI assigned
Oct 6, 2023
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 11, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 34012606A IN Primary

Addresses

Primary practice location

5920 Decatur Rd
Fort Wayne, IN 46816-3640

Mailing address

5920 Decatur Rd
Fort Wayne, IN 46816-3640
Phone (260) 424-4908

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
I20260205002348 IN Practitioner - Clinical Social Worker 3779062237 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2022
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

4150 Illinois Rd
Fort Wayne, IN 46804-1208

66 E Flagler St
Miami, FL 33130-1807

6619 Brotherhood Way
Fort Wayne, IN 46825-4226

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
33011873AINMDSocial Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Crosswinds Inc CurrentSince Dec 31, 2025 Accepting new patients
Ywca Northeast Indiana Inc PastSince Oct 8, 2023 Accepting new patients

Locations

4150 Illinois Rd
Fort Wayne, IN 46804
Phone (260) 240-4945

5110 Commerce Square Dr
Ste F
Indianapolis, IN 46237
Phone (317) 540-3314

Organizations & group practices 3

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

NPI Registry JSON

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

{
    "created_epoch": "1696550400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1789084800000",
    "number": "1609657642",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5920 DECATUR RD",
            "city": "FORT WAYNE",
            "state": "IN",
            "postal_code": "468163640",
            "telephone_number": "260-424-4908"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5920 DECATUR RD",
            "city": "FORT WAYNE",
            "state": "IN",
            "postal_code": "468163640",
            "telephone_number": "260-424-4908"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TOUNTZIOS",
        "first_name": "STEFANI",
        "middle_name": "M",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-10-06",
        "last_updated": "2026-09-11",
        "certification_date": "2026-09-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "IN",
            "license": "34012606A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Wayne, IN

Sources for this page

Verify at the official NPI Registry.