Ywca Northeast Indiana Inc

Primary specialty

Substance Abuse Rehabilitation FacilityTaxonomy code 324500000X

Legal business name

YWCA NORTHEAST INDIANA INC

Practice address

1313 W Washington Center Rd
Fort Wayne, IN 46825-4142

Phone

(260) 424-4908

NPI assigned

Feb 4, 2019

Organization subpart

No

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

Authorized official

Name

Mrs. Michelle Banks

Title

Chief Financial Officer

Phone

(260) 424-4908

Specialties & licenses 4

Addresses

Medicare fee-for-service enrollment

Enrolled in IN

Enrollment records 1

Locations

Practitioners 7

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Haley Criswell, LCSW

  • Clinical Social Worker
  • Albion, IN
  • NPI 1255155818
  Medicare reassignment NPD
• Nicole Johnson-Smith

  • Mental Health Counselor
  • Lagrange, IN
  • NPI 1548816374
  Medicare reassignment NPD
• John F Newbauer, ED.D.

  • Psychologist
  • Fort Wayne, IN
  • NPI 1891818126
  Medicare reassignment NPD
• Brittany Ogden, MSW, LCSW, CSAYC

  • Clinical Social Worker
  • Fort Wayne, IN
  • NPI 1043982119
  Medicare reassignment NPD
• Andrea Renee Robinson, MSW

  • Social Worker
  • Fort Wayne, IN
  • NPI 1003593138
  NPD (past)
• Stefani M Tountzios

  • Clinical Social Worker
  • Fort Wayne, IN
  • NPI 1609657642
  NPD (past)
• Ollie R Fisher, LPC

  • Professional Counselor
  • Mesa, AZ
  • NPI 1649996430

  Mental Health

  NPD (past)

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

{
    "created_epoch": "1549238400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1740441600000",
    "number": "1629533658",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1313 W WASHINGTON CENTER RD",
            "city": "FORT WAYNE",
            "state": "IN",
            "postal_code": "468254142"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1313 W WASHINGTON CENTER RD",
            "city": "FORT WAYNE",
            "state": "IN",
            "postal_code": "468254142",
            "telephone_number": "260-424-4908"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2417 Fairfield Ave",
            "address_purpose": "LOCATION",
            "city": "Fort Wayne",
            "state": "IN",
            "postal_code": "468071210",
            "country_code": "US",
            "telephone_number": "260-424-4908",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "5920 Decatur Rd",
            "address_purpose": "LOCATION",
            "city": "Fort Wayne",
            "state": "IN",
            "postal_code": "468163640",
            "country_code": "US",
            "telephone_number": "260-424-4908",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "YWCA NORTHEAST INDIANA INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-02-04",
        "last_updated": "2025-02-25",
        "certification_date": "2025-02-25",
        "status": "A",
        "authorized_official_last_name": "BANKS",
        "authorized_official_first_name": "MICHELLE",
        "authorized_official_title_or_position": "CHIEF FINANCIAL OFFICER",
        "authorized_official_telephone_number": "260-424-4908",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "103T00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychologist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "177F00000X",
            "taxonomy_group": "",
            "desc": "Lodging",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "324500000X",
            "taxonomy_group": "",
            "desc": "Substance Abuse Rehabilitation Facility",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Anda Yurisich
• Bradley Yurkanin
• Joseph Yurkanin, M.D.
• Michael Yurkanin, M.D.
• Mukhabbat Yusupova, MA
• Milan Za, MD
• Judy L. Zacher, M.D.
• Kathryn Zachman-Pavell, O.D.
• Matthew Ryan Zachman, PTA
• Thomas Robert Zachman, O.D.

• Substance Abuse Rehabilitation Facility in Fort Wayne, IN
• Providers in Fort Wayne, IN by specialty
• Substance Abuse Rehabilitation Facility in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 25, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.