Active NPI
Brooke Nicole Sellhorn, LMFT
- Marriage & Family Therapist
- Fort Wayne, IN
National Provider Identifier
1700221330
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Marriage & Family Therapist
- License
- 35001729A
- Practice address
- 9417 Saint Joe Center Rd
Fort Wayne, IN 46835-9259 - Phone
- (260) 485-3692
- NPI assigned
- May 9, 2013
- 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 |
|---|---|---|---|---|
| Marriage & Family Therapist | 106H00000X | 35001729A | IN | Primary |
Addresses
Primary practice location
9417 Saint Joe Center Rd
Fort Wayne, IN 46835-9259
Mailing address
3717 Oakhurst Dr
Fort Wayne, IN 46815-6238
Phone (260) 409-0609
Other practice location 1
7136 Gettysburg Pike
Fort Wayne, IN 46804-5680
Phone (260) 745-3322
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1700221330 | Other | IN | 01 - INDIVIDUAL |
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 |
|---|---|---|---|
| 35001729A | IN | MD | Marriage & Family Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Crosswinds Inc | Past | Accepting new patients | |
| Brooke Sellhorn LLC | Marriage & Family Therapist | Past | Accepting new patients |
Organizations & group practices 2
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.
-
- Marriage & Family Therapist
- Fort Wayne, IN
- NPI 1275040859
-
- Counselor
- Fort Wayne, IN
- NPI 1497170427
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1368057600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1521244800000",
"number": "1700221330",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3717 OAKHURST DR",
"city": "FORT WAYNE",
"state": "IN",
"postal_code": "468156238",
"telephone_number": "260-409-0609"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "9417 SAINT JOE CENTER RD",
"city": "FORT WAYNE",
"state": "IN",
"postal_code": "468359259",
"telephone_number": "260-485-3692"
}
],
"practiceLocations": [
{
"address_1": "7136 Gettysburg Pike",
"address_purpose": "LOCATION",
"city": "Fort Wayne",
"state": "IN",
"postal_code": "468045680",
"country_code": "US",
"telephone_number": "260-745-3322",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "SELLHORN",
"first_name": "BROOKE",
"middle_name": "NICOLE",
"credential": "LMFT",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2013-05-09",
"last_updated": "2018-03-17",
"status": "A"
},
"taxonomies": [
{
"code": "106H00000X",
"taxonomy_group": "",
"desc": "Marriage & Family Therapist",
"state": "IN",
"license": "35001729A",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "01 - INDIVIDUAL",
"identifier": "1700221330",
"state": "IN"
}
],
"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 17, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.