NPIMap

Organization Active NPI

Catholic Charities of the Diocese of Fort Wayne-South Bend, Inc.

  • Social Worker
  • Fort Wayne, IN
National Provider Identifier
1811047608
Registry record updated Jan 20, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Social WorkerTaxonomy code 104100000X
Legal business name
CATHOLIC CHARITIES OF THE DIOCESE OF FORT WAYNE-SOUTH BEND, INC.
Practice address
915 South Clinton
Fort Wayne, IN 46802
Phone
(260) 422-5625
Fax
(260) 422-5657
NPI assigned
Jan 12, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 20, 2017

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

Authorized official

Name
Mrs. Gloria Whitcraft, M.S. ED, LMFT
Title
Chief Executive Officer
Phone
(260) 422-5625

Specialties & licenses 5

Specialty (taxonomy)CodeLicenseStatePrimary
CounselorGroup: 193200000X MULTI-SPECIALTY GROUP 101Y00000X
Mental Health CounselorGroup: 193200000X MULTI-SPECIALTY GROUP 101YM0800X
Social WorkerGroup: 193200000X MULTI-SPECIALTY GROUP 104100000X Primary
Clinical Social WorkerGroup: 193200000X MULTI-SPECIALTY GROUP 1041C0700X
Marriage & Family TherapistGroup: 193200000X MULTI-SPECIALTY GROUP 106H00000X

Addresses

Primary practice location

915 South Clinton
Fort Wayne, IN 46802

Mailing address

PO Box 10630
Fort Wayne, IN 46853-0630
Phone (260) 422-5625

Other identifiers 1

IdentifierTypeStateIssuer
200100590MedicaidIN

Other names 1

  • Catholic Charities Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Catholic Charities2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Locations

915 S Clinton St
Fort Wayne, IN 46802
Phone (260) 422-5625

1328 W Dragoon Trl
Mishawaka, IN 46544
Phone (574) 626-4117

Practitioners & affiliated clinicians

Practitioners 6

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1168560000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1484870400000",
    "number": "1811047608",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 10630",
            "city": "FORT WAYNE",
            "state": "IN",
            "postal_code": "468530630",
            "telephone_number": "260-422-5625",
            "fax_number": "260-422-5657"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "915 SOUTH CLINTON",
            "city": "FORT WAYNE",
            "state": "IN",
            "postal_code": "46802",
            "telephone_number": "260-422-5625",
            "fax_number": "260-422-5657"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CATHOLIC CHARITIES OF THE DIOCESE OF FORT WAYNE-SOUTH BEND, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-12",
        "last_updated": "2017-01-20",
        "status": "A",
        "authorized_official_last_name": "WHITCRAFT",
        "authorized_official_first_name": "GLORIA",
        "authorized_official_title_or_position": "CHIEF EXECUTIVE OFFICER",
        "authorized_official_telephone_number": "260-422-5625",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "M.S. ED, LMFT"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "104100000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Social Worker",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "106H00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Marriage & Family Therapist",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200100590",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Catholic Charities",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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 Jan 20, 2017; 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.