Rebecca Sue Berghorn, LMFT
Individual provider Active NPI Marriage & Family Therapist · Fort Wayne, IN
NPI 1952409427 · NPPES record last updated Dec 8, 2009
Key facts
- NPI
- 1952409427
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Marriage & Family Therapist 106H00000X
- License
- 35001692 (IN)
- Practice address
- 3948 New Vision Dr Ste D
Fort Wayne, IN 46845-1721 - Phone
- (260) 407-7285
- Fax
- (260) 407-0094
- NPI assigned
- Sep 20, 2006
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 2
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 35001692 | IN | MD | Marriage & Family Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Cornerstone Counseling & Consulting, P.C, | Past | Accepting new patients | |
| Vision Counseling and Psychological Services, PC | Past | Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Marriage & Family Therapist | 106H00000X | 35001692 | IN | Yes |
Addresses
Primary practice location
3948 New Vision Dr Ste D
Fort Wayne, IN 46845-1721
Mailing address
3948 New Vision Dr Ste D
Fort Wayne, IN 46845-1721
Phone (260) 407-7285
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 200530260A | Medicaid | IN |
Other providers in Fort Wayne, IN
- Greg B Berghoff
- Lucas Berghoff
- Margaret Berghoff
- Robin Berghoff
- William J Berghoff
- Andrew Jason Bergman
- Carmen Sue Bergman
- Mary Bergstrom
- Ashley Berish
- Ronald John Berish
All providers in Fort Wayne, IN · Marriage & Family Therapist in Indiana
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Dec 8, 2009. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.