Charles Balke, PSY.D.

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

20042479A Issued in IN

Practice address

7311A W Jefferson Blvd
Fort Wayne, IN 46804-6237

Phone

(260) 471-8033

Fax

(260) 471-8107

NPI assigned

Oct 23, 2013

Last updated

Jul 8, 2022By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

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

Specialty

Clinical Psychologist

Education

Other, 2007

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Von Bargen Associates IncGroup PAC ID 8426011792, 2 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Von Bargen Associates, Inc.

  dba Directions In Aging

  • Clinical Psychologist
  • Fort Wayne, IN
  • NPI 1366492043
  Medicare reassignment Care Compare group NPD
• Von Bargen Associates, Inc.

  • Mental Health Counselor
  • Fort Wayne, IN
  • NPI 1811004526
  NPD

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

{
    "created_epoch": "1382486400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1657238400000",
    "number": "1790113009",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7311A W JEFFERSON BLVD",
            "city": "FORT WAYNE",
            "state": "IN",
            "postal_code": "468046237",
            "telephone_number": "260-471-8033",
            "fax_number": "260-471-8107"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7311A W JEFFERSON BLVD",
            "city": "FORT WAYNE",
            "state": "IN",
            "postal_code": "468046237",
            "telephone_number": "260-471-8033",
            "fax_number": "260-471-8107"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "208 S Maple St",
            "address_purpose": "LOCATION",
            "city": "Pierceton",
            "state": "IN",
            "postal_code": "465629086",
            "country_code": "US",
            "telephone_number": "574-594-3815",
            "fax_number": "574-594-1653",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BALKE",
        "first_name": "CHARLES",
        "credential": "PSY.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2013-10-23",
        "last_updated": "2022-07-08",
        "certification_date": "2022-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "IN",
            "license": "20042479A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Rahul Atul Bakhle
• Jana Marie Bakle, RN
• Aya Balan
• Balanced Counseling and Consultation
• Patricia E Baldwin-Bodie, RNC, WHNP
• Bryce Ball
• Diana M Ball, LCSW
• Lyndsey Brooke Ball, FNP
• Grace Ballinger, PHARMD
• Jennifer P Ballinger

• Clinical Psychologist in Fort Wayne, IN
• Providers in Fort Wayne, IN by specialty
• Clinical Psychologist in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.