Calla Granger

Individual provider Active NPI Mental Health Counselor · Bluffton, IN

NPI 1730749706 · NPPES record last updated Apr 20, 2020

Key facts

NPI
1730749706
Entity type
Individual (NPI type 1)
Primary specialty
Mental Health Counselor 101YM0800X
License
39003564A (IN)
Practice address
1115 S Main St
Bluffton, IN 46714-3616
Phone
(260) 824-1071
Fax
(260) 824-5578
NPI assigned
Jun 20, 2019
Sex
Female
Sole proprietor
No

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.

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
39003564AINMDMental Health Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Park Center Inc Current
since Jan 1, 2024
Accepting new patients
Park Center Inc Past
since Apr 26, 2020
Accepting new patients

Locations

1115 S Main St
Bluffton, IN 46714
Phone (260) 824-1071

909 E State Blvd
Fort Wayne, IN 46805
Phone (260) 481-2718

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X 39003564A IN Yes

Addresses

Primary practice location

1115 S Main St
Bluffton, IN 46714-3616

Mailing address

909 E State Blvd
Fort Wayne, IN 46805-3458
Phone (260) 482-9125

Other practice location 1

322 N Main St
Kokomo, IN 46901-4622
Phone (765) 453-8555

Other names

  • Calla Wolfe Former name

Other providers in Bluffton, IN

All providers in Bluffton, IN · Mental Health Counselor in Indiana

Sources for this page

Verify at the official NPI Registry.