Mary Lisa Barta, MS, LMFTA
Individual provider Active NPI Marriage & Family Therapist · Fort Wayne, IN
NPI 1972769735 · NPPES record last updated Apr 12, 2018
Key facts
- NPI
- 1972769735
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Marriage & Family Therapist 106H00000X
- License
- 35001710 (IN)
- Practice address
- 10315E Dawson'S Creek Blvd
Fort Wayne, IN 46825-1721 - Phone
- (260) 387-6340
- NPI assigned
- Jul 31, 2008
- Sex
- Female
- Sole proprietor
- Yes
Organizations & group practices 4
Medicare Care Compare profile
- Specialty
- Marriage and Family Therapist
- Education
- Other, 2008
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
Practice addresses (Care Compare)
10315 Dawsons Creek Blvd
Suite E
Fort Wayne, IN 46825-1912
Phone (260) 387-6340
10315 Dawsons Creek Blvd E
Fort Wayne, IN 46825-1912
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in IN
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: No · Power mobility devices: No · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20240816003415 | IN | Practitioner - Marriage and Family Therapist | 6002354347 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Master of Science
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 35001710 | IN | MD | Marriage & Family Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Mary Lisa Barta LLC | Marriage & Family Therapist | Current |
Accepting new patients |
| Vision Counseling and Psychological Services, PC | Past | Accepting new patients | |
| Cornerstone Counseling & Consulting, P.C, | Past | Accepting new patients | |
| Bonnie Kiser LLC | Past | Accepting new patients |
Locations
10315 Dawsons Creek Blvd
Ste E
Fort Wayne, IN 46825
Phone (260) 387-3640
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Marriage & Family Therapist | 106H00000X | 35001710 | IN | Yes |
Addresses
Primary practice location
10315E Dawson'S Creek Blvd
Fort Wayne, IN 46825-1721
Mailing address
10315E Dawson'S Creek Blvd
Fort Wayne, IN 46825-1721
Phone (260) 387-6340
Other practice location 1
3948 New Vision Dr Ste D
Fort Wayne, IN 46845-1721
Phone (260) 407-7285 ext. 103
Other practice location 2
10315 Dawsons Creek Blvd
Fort Wayne, IN 46825-1912
Phone (260) 387-6340 ext. 103
Other practice location 3
10315 Dawsons Creek Blvd
Fort Wayne, IN 46825-1912
Phone (260) 387-6340 ext. 103
Other providers in Fort Wayne, IN
- Melanie S Barrido
- Amanda Rose Barrie
- Sidney Barrier
- Cindy Bradtmiller Barron
- Barry J Close OD, Inc.
- Lisa S Bartelheim
- William Barth
- Lynda Judith Bartholomew
- Mya Bartholomew
- Samantha Bartley
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 Apr 12, 2018. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.