NPIMap

Organization Active NPI

Consulting & Counseling Associates, LLC

  • Clinical Social Worker
  • Fort Wayne, IN
National Provider Identifier
1962432971
Registry record updated Apr 3, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
Legal business name
CONSULTING & COUNSELING ASSOCIATES, LLC
Practice address
4109 W Jefferson Blvd
Ste a
Fort Wayne, IN 46804-6894
Phone
(260) 486-5251
Fax
(260) 486-5058
NPI assigned
Jul 4, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 3, 2024

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

Authorized official

Name
Mrs. Kara Hale
Title
Practice Administrator
Phone
(260) 486-5251

Specialties & licenses 8

Specialty (taxonomy)CodeLicenseStatePrimary
CounselorGroup: 193200000X MULTI-SPECIALTY GROUP 101Y00000X 39000309A IN
Mental Health CounselorGroup: 193200000X MULTI-SPECIALTY GROUP 101YM0800X
PsychologistGroup: 193200000X MULTI-SPECIALTY GROUP 103T00000X 20130063A IN
Social WorkerGroup: 193200000X MULTI-SPECIALTY GROUP 104100000X 34004475A IN
Social WorkerGroup: 193200000X MULTI-SPECIALTY GROUP 104100000X 34001306A IN
Clinical Social WorkerGroup: 193200000X MULTI-SPECIALTY GROUP 1041C0700X Primary
Marriage & Family TherapistGroup: 193200000X MULTI-SPECIALTY GROUP 106H00000X 3900246A IN
Marriage & Family TherapistGroup: 193200000X MULTI-SPECIALTY GROUP 106H00000X

Addresses

Primary practice location

4109 W Jefferson Blvd
Ste a
Fort Wayne, IN 46804-6894

Mailing address

4109 W Jefferson Blvd
Ste a
Fort Wayne, IN 46804-6894
Phone (260) 486-5251

Other names 1

  • Consulting & Counseling Associates, Inc. Former legal business name

National Provider Directory

National Provider Directory

Locations

4214 Hobson Ct
Fort Wayne, IN 46815
Phone (260) 486-5251

4109 W Jefferson Blvd
Ste A
Fort Wayne, IN 46804
Phone (260) 486-5251

Practitioners & affiliated clinicians

Practitioners 11

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

NPI Registry JSON

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

{
    "created_epoch": "1151971200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1712102400000",
    "number": "1962432971",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4109 W JEFFERSON BLVD",
            "address_2": "STE A",
            "city": "FORT WAYNE",
            "state": "IN",
            "postal_code": "468046894",
            "telephone_number": "260-486-5251",
            "fax_number": "260-486-5058"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4109 W JEFFERSON BLVD",
            "address_2": "STE A",
            "city": "FORT WAYNE",
            "state": "IN",
            "postal_code": "468046894",
            "telephone_number": "260-486-5251",
            "fax_number": "260-486-5058"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CONSULTING & COUNSELING ASSOCIATES, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-04",
        "last_updated": "2024-04-03",
        "certification_date": "2020-01-06",
        "status": "A",
        "authorized_official_last_name": "HALE",
        "authorized_official_first_name": "KARA",
        "authorized_official_title_or_position": "PRACTICE ADMINISTRATOR",
        "authorized_official_telephone_number": "260-486-5251",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor",
            "state": "IN",
            "license": "39000309A",
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "103T00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychologist",
            "state": "IN",
            "license": "20130063A",
            "primary": false
        },
        {
            "code": "104100000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Social Worker",
            "state": "IN",
            "license": "34004475A",
            "primary": false
        },
        {
            "code": "104100000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Social Worker",
            "state": "IN",
            "license": "34001306A",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "106H00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Marriage & Family Therapist",
            "state": "IN",
            "license": "3900246A",
            "primary": false
        },
        {
            "code": "106H00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Marriage & Family Therapist",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Consulting & Counseling Associates, Inc.",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

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 Apr 3, 2024; 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.