NPIMap

Organization Active NPI

Integrative Counseling Solutions LLC

  • Clinical Social Worker
  • Fort Wayne, IN
National Provider Identifier
1699142844
Registry record updated Sep 13, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
IN34004652A Issued in IN
Legal business name
INTEGRATIVE COUNSELING SOLUTIONS LLC
Practice address
2420 N Coliseum Blvd
Suite 201
Fort Wayne, IN 46805-3139
Phone
(260) 498-8009
Fax
(260) 498-8009
NPI assigned
Aug 24, 2015
Last updated
Sep 13, 2015By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 13, 2015

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

Authorized official

Name
Heather L Johnston, LCSWNPI 1053687145
Title
Co-Owner
Phone
(260) 498-8009

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Counselor 101Y00000X
Clinical Social Worker 1041C0700X IN34004652A IN Primary

Addresses

Primary practice location

2420 N Coliseum Blvd
Suite 201
Fort Wayne, IN 46805-3139

Mailing address

2420 N Coliseum Blvd
Suite 201
Fort Wayne, IN 46805-3139
Phone (260) 498-8009

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1440374400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1442102400000",
    "number": "1699142844",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2420 N COLISEUM BLVD",
            "address_2": "SUITE 201",
            "city": "FORT WAYNE",
            "state": "IN",
            "postal_code": "468053139",
            "telephone_number": "260-498-8009",
            "fax_number": "260-498-8009"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2420 N COLISEUM BLVD",
            "address_2": "SUITE 201",
            "city": "FORT WAYNE",
            "state": "IN",
            "postal_code": "468053139",
            "telephone_number": "260-498-8009",
            "fax_number": "260-498-8009"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "INTEGRATIVE COUNSELING SOLUTIONS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-08-24",
        "last_updated": "2015-09-13",
        "status": "A",
        "authorized_official_last_name": "JOHNSTON",
        "authorized_official_first_name": "HEATHER",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "CO-OWNER",
        "authorized_official_telephone_number": "260-498-8009",
        "authorized_official_credential": "LCSW"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "IN",
            "license": "IN34004652A",
            "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 Sep 13, 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.

Verify at the official NPI Registry.