Organization Active NPI

Lutheran Social Services of Indiana Inc.

  • Counselor
  • Fort Wayne, IN
National Provider Identifier
1861636136
Registry record updated Mar 30, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
CounselorTaxonomy code 101Y00000X
Legal business name
LUTHERAN SOCIAL SERVICES OF INDIANA INC.
Practice address
333 E Lewis St
Fort Wayne, IN 46802-3139
Phone
(260) 426-3347
Fax
(260) 426-2248
NPI assigned
Apr 29, 2009
Organization subpart
No

Authorized official

NPPES NPI Registry
Name
Angela Moellering
Title
President/Ceo
Phone
(260) 242-6633

Practitioners 12

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

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IN

Medicare enrollment records 1

Medicare enrollment files
Enrollment IDStateProvider typePAC IDDetails
O20220425001958 IN Part B Supplier - Clinic/Group Practice 7416344262 Receives reassigned benefits from 7 practitioners
Practice locations: Fort Wayne, IN

National Provider Directory

National Provider Directory

Locations

333 E Lewis St
Fort Wayne, IN 46802
Phone (260) 426-3347

4031 N Clinton St
Fort Wayne, IN 46805
Phone (260) 426-3347

Specialties & licenses 1

NPPES NPI Registry
Specialty (taxonomy)CodeLicenseStatePrimary
CounselorGroup: 193200000X MULTI-SPECIALTY GROUP 101Y00000X Primary

Addresses

NPPES NPI Registry

Primary practice location

333 E Lewis St
Fort Wayne, IN 46802-3139

Mailing address

333 E Lewis St
Fort Wayne, IN 46802-3139
Phone (260) 426-3347

Other identifiers 1

NPPES NPI Registry
IdentifierTypeStateIssuer
200072230MedicaidIN

Other names 1

NPPES NPI Registry
  • Lutheran Social Services of Indiana Doing business as

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Mar 30, 2022.

{
    "created_epoch": "1240963200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1648598400000",
    "number": "1861636136",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "333 E LEWIS ST",
            "city": "FORT WAYNE",
            "state": "IN",
            "postal_code": "468023139",
            "telephone_number": "260-426-3347",
            "fax_number": "260-426-2248"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "333 E LEWIS ST",
            "city": "FORT WAYNE",
            "state": "IN",
            "postal_code": "468023139",
            "telephone_number": "260-426-3347",
            "fax_number": "260-426-2248"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LUTHERAN SOCIAL SERVICES OF INDIANA INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-04-29",
        "last_updated": "2022-03-30",
        "certification_date": "2022-03-30",
        "status": "A",
        "authorized_official_last_name": "MOELLERING",
        "authorized_official_first_name": "ANGELA",
        "authorized_official_title_or_position": "PRESIDENT/CEO",
        "authorized_official_telephone_number": "260-242-6633"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200072230",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Lutheran Social Services of Indiana",
            "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 Mar 30, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.