Individual provider Active NPI

Stephen Alexander Konz, LMHC

  • Mental Health Counselor
  • Fort Wayne, IN
National Provider Identifier
1780680694
Registry record updated Aug 30, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
39001468A Issued in IN
Practice address
2100 Goshen Rd
Fort Wayne, IN 46808-1493
Phone
(260) 471-3500
Fax
(260) 471-4263
NPI assigned
Jun 24, 2005
Last updated
Aug 30, 2013By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 30, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X 39001468A IN Primary

Addresses

Primary practice location

2100 Goshen Rd
Fort Wayne, IN 46808-1493

Mailing address

850 N Harrison St
C/O Anne Lawson
Warsaw, IN 46580-3163
Phone (574) 267-7169

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IN
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240119001886 IN Practitioner - Mental Health Counselor 2264884709 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
39001468AINMDMental Health Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Bowen Health Inc Current Accepting new patients
Bowen Health Inc CurrentSince Jan 1, 2024 Accepting new patients

Locations

2100 Goshen Rd
Fort Wayne, IN 46808
Phone (260) 471-3500

255 N Miami St
Wabash, IN 46992
Phone (260) 563-8446

850 N Harrison St
Warsaw, IN 46580
Phone (219) 267-7169

2621 E Jefferson St
Warsaw, IN 46580
Phone (574) 269-0573

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1119571200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1377820800000",
    "number": "1780680694",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "850 N HARRISON ST",
            "address_2": "C/O ANNE LAWSON",
            "city": "WARSAW",
            "state": "IN",
            "postal_code": "465803163",
            "telephone_number": "574-267-7169",
            "fax_number": "574-269-5573"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2100 GOSHEN RD",
            "city": "FORT WAYNE",
            "state": "IN",
            "postal_code": "468081493",
            "telephone_number": "260-471-3500",
            "fax_number": "260-471-4263"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KONZ",
        "first_name": "STEPHEN",
        "middle_name": "ALEXANDER",
        "credential": "LMHC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-06-24",
        "last_updated": "2013-08-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "IN",
            "license": "39001468A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Wayne, IN

Sources for this page

Verify at the official NPI Registry.