Active NPI
Lutheran Social Services of Indiana Inc.
- Counselor
- Fort Wayne, IN
National Provider Identifier
1861636136
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Counselor
- 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.
-
- Counselor
- Fort Wayne, IN
- NPI 1962015404
-
- Clinical Social Worker
- Fort Wayne, IN
- NPI 1639699366
-
- Clinical Social Worker
- Fort Wayne, IN
- NPI 1972054880
-
- Mental Health Counselor
- Fort Wayne, IN
- NPI 1215454335
-
- Social Worker
- Fort Wayne, IN
- NPI 1396296091
-
- Mental Health Counselor
- Fort Wayne, IN
- NPI 1144771999
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in IN
Medicare enrollment records 1
Medicare enrollment files| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| 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 DirectoryLocations
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) | Code | License | State | Primary |
|---|---|---|---|---|
| Counselor | 101Y00000X | Primary |
Addresses
NPPES NPI RegistryPrimary 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| Identifier | Type | State | Issuer |
|---|---|---|---|
| 200072230 | Medicaid | IN |
Other names 1
NPPES NPI Registry- Lutheran Social Services of Indiana
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.