Susan Marie Tielker-Sharpe, LCSW LMFT ACSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

34000886A Issued in IN

Practice address

4656 W Jefferson Blvd
Suite 285
Ft Wayne, IN 46804

Phone

(260) 422-9372

Fax

(260) 422-0843

NPI assigned

Jun 15, 2006

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 3

Other names 1

• Susan Marie Tielker 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.

• Parkview Hospital, Inc.

  • Trauma Surgery Physician
  • Fort Wayne, IN
  • NPI 1669576997
  NPD (past)

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

{
    "created_epoch": "1150329600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1363651200000",
    "number": "1871537753",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4656 W JEFFERSON BLVD",
            "address_2": "SUITE 285",
            "city": "FT WAYNE",
            "state": "IN",
            "postal_code": "46804",
            "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": "SUITE 285",
            "city": "FT WAYNE",
            "state": "IN",
            "postal_code": "46804",
            "telephone_number": "260-422-9372",
            "fax_number": "260-422-0843"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TIELKER-SHARPE",
        "first_name": "SUSAN",
        "middle_name": "MARIE",
        "name_prefix": "Mrs.",
        "credential": "LCSW LMFT ACSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-06-15",
        "last_updated": "2013-03-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "IN",
            "license": "35000408ALMFT",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "IN",
            "license": "34000886A",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MAGELLAN",
            "identifier": "150990000",
            "state": "IN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM",
            "identifier": "000000299295",
            "state": "IN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "4352922",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "SUSAN",
            "last_name": "TIELKER",
            "middle_name": "MARIE",
            "credential": "LCSW LMFT",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Corey Tibbs
• Melinda Tiburcio
• Sonya Tichler, PTA
• Stewart Gregory Tidwell, MA, LMHC
• Jonathan Alvin Tiedeman, SCHOOL PSYCHOLOGIST
• Richard Elmer Tielker, M.D.
• Kelsey E. Tiernon, MA
• Paige Tiernon
• Ian Tiffany, RBT
• Trisha Rose Tiffany, LPN

• 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 Mar 19, 2013; 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.