Active NPI
Jodie Hively, MSED., LMFTA
- Mental Health Counselor
- Fort Wayne, IN
National Provider Identifier
1619360898
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Mental Health Counselor
- License
- 85000194A
- Practice address
- 3842 New Vision Dr
Fort Wayne, IN 46845-1708 - Phone
- (260) 471-2300
- NPI assigned
- Mar 11, 2015
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | 85000194A | IN | Primary |
Addresses
Primary practice location
3842 New Vision Dr
Fort Wayne, IN 46845-1708
Mailing address
3842 New Vision Dr
Fort Wayne, IN 46845-1708
Phone (260) 471-2300
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 85000194A | IN | MD | Mental Health Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1426032000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1426032000000",
"number": "1619360898",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3842 NEW VISION DR",
"city": "FORT WAYNE",
"state": "IN",
"postal_code": "468451708",
"telephone_number": "260-471-2300"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3842 NEW VISION DR",
"city": "FORT WAYNE",
"state": "IN",
"postal_code": "468451708",
"telephone_number": "260-471-2300"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HIVELY",
"first_name": "JODIE",
"credential": "MSED., LMFTA",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2015-03-11",
"last_updated": "2015-03-11",
"status": "A"
},
"taxonomies": [
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": "IN",
"license": "85000194A",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}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 Mar 11, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.