Christine Ann Motherwell, MSW, LMHC, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

34004390A Issued in IN

Practice address

2100 Goshen Rd
260
Fort Wayne, IN 46808-1493

Phone

(260) 471-3500

Fax

(260) 471-4263

NPI assigned

Jul 20, 2005

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1121817600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1575590400000",
    "number": "1730188798",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2422 PRESTON DR",
            "city": "FORT WAYNE",
            "state": "IN",
            "postal_code": "468156852",
            "telephone_number": "260-602-5612"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2100 GOSHEN RD",
            "address_2": "260",
            "city": "FORT WAYNE",
            "state": "IN",
            "postal_code": "468081493",
            "telephone_number": "260-471-3500",
            "fax_number": "260-471-4263"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOTHERWELL",
        "first_name": "CHRISTINE",
        "middle_name": "ANN",
        "name_prefix": "Ms.",
        "credential": "MSW, LMHC, LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-07-20",
        "last_updated": "2019-12-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "IN",
            "license": "34004390A",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100156770A",
            "state": "IN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200283190A",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Mir Abdul Karim Moshref, MD
• Mustafa Moshref
• Jessica Moss
• Caleb Andrew Mossburg, PHARMD
• Ambria Moten, M.D.
• Krista Motter, RPH
• Megan Ashleigh Motter, RDN
• Lisa M Motz, NP
• Brittany Mount
• Breale Mousavi, RBT

• All providers in Fort Wayne, IN
• Clinical Social Worker in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 6, 2019; 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.