Debra Lynn Roesner, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

34003614A Issued in IN

Practice address

4656 W Jefferson Blvd
Suite285
Fort Wayne, IN 46804-6857

Phone

(260) 422-9372

Fax

(260) 422-0843

NPI assigned

Jul 21, 2010

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other names 1

• Debra Lynn Nelson-Stewart Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

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.

• Park Center Inc

  • Psychiatric Hospital
  • Fort Wayne, IN
  • NPI 1457772402
  NPD (past)

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

{
    "created_epoch": "1279670400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1307318400000",
    "number": "1811200785",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4656 W JEFFERSON BLVD",
            "address_2": "SUITE285",
            "city": "FORT WAYNE",
            "state": "IN",
            "postal_code": "468046857",
            "telephone_number": "260-422-9372",
            "fax_number": "260-422-0843"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4656 W JEFFERSON BLVD",
            "address_2": "SUITE285",
            "city": "FORT WAYNE",
            "state": "IN",
            "postal_code": "468046857",
            "telephone_number": "260-422-9372",
            "fax_number": "260-422-0843"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROESNER",
        "first_name": "DEBRA",
        "middle_name": "LYNN",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2010-07-21",
        "last_updated": "2011-06-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "IN",
            "license": "34003614A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "DEBRA",
            "last_name": "NELSON-STEWART",
            "middle_name": "LYNN",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Zhagya Rodriguez
• Kelli Rose Roe, NP
• Ludmila Roebel, NURSE PRACTITIONER
• Ron James Roeble, CTRS
• Austin Roemer, RBT
• Robert D. Roether, MD
• Aimee Rogers, RN
• Angel Unique Rogers
• Brittony C Rogers, NP
• Christiane Rogers

• Clinical Social Worker in Fort Wayne, IN
• Providers in Fort Wayne, IN by specialty
• Clinical Social Worker in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 6, 2011; 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.