Individual provider Active NPI

Emily Marie Liechty, MSW

  • Clinical Social Worker
  • Fort Wayne, IN
National Provider Identifier
1821438003
Registry record updated Aug 18, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
34007392A Issued in IN
Practice address
909 E State Blvd
Fort Wayne, IN 46805-3404
Phone
(260) 481-2700
Fax
(260) 481-2838
NPI assigned
Jul 2, 2013
Last updated
Aug 18, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 18, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 34007392A IN Primary

Addresses

Primary practice location

909 E State Blvd
Fort Wayne, IN 46805-3404

Mailing address

909 E State Blvd
Fort Wayne, IN 46805-3404
Phone (260) 481-2700

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
I20160126000119 IN Practitioner - Clinical Social Worker 9234432204 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2013
Medicare assignment
May accept Medicare assignment
Telehealth
Offers telehealth services
Group practices
Wellhome Psychology PCGroup PAC ID 3476965070, 2 clinicians
RDR Devine LLCGroup PAC ID 9931515889, 11 clinicians

Practice addresses (Care Compare)

417 W 81St Ave
Suite 132
Merrillville, IN 46410-5317
Phone (219) 804-6262

429 E Dupont Rd
Suite 1213
Fort Wayne, IN 46825-2051
Phone (219) 804-6262

6157 Stoney Creek Dr
Fort Wayne, IN 46825-4409
Phone (260) 570-4518

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Wellhome Psychology, PC CurrentSince Jun 1, 2025 Accepting new patients

Locations

429 E DuPont Rd
Fort Wayne, IN 46825
Phone (260) 297-3773

417 W 81st Ave
Merrillville, IN 46410
Phone (219) 444-5944

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": "1372723200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1755475200000",
    "number": "1821438003",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "909 E STATE BLVD",
            "city": "FORT WAYNE",
            "state": "IN",
            "postal_code": "468053404",
            "telephone_number": "260-481-2700",
            "fax_number": "260-481-2838"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "909 E STATE BLVD",
            "city": "FORT WAYNE",
            "state": "IN",
            "postal_code": "468053404",
            "telephone_number": "260-481-2700",
            "fax_number": "260-481-2838"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LIECHTY",
        "first_name": "EMILY",
        "middle_name": "MARIE",
        "name_prefix": "Ms.",
        "credential": "MSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-07-02",
        "last_updated": "2025-08-18",
        "certification_date": "2025-08-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "IN",
            "license": "34007392A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Wayne, IN

Sources for this page

Verify at the official NPI Registry.