NPIMap

Organization Active NPI

Lisa Heller, LCSW, LLC

  • Community/Behavioral Health Agency
  • Fort Wayne, IN
National Provider Identifier
1972956522
Registry record updated Jul 19, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Behavioral Health AgencyTaxonomy code 251S00000X
License
34002636A Issued in IN
Legal business name
LISA HELLER, LCSW, LLC
Practice address
10315 Dawsons Creek Blvd Ste E
Fort Wayne, IN 46825-1912
Phone
(260) 437-9022
NPI assigned
Jul 19, 2016
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 19, 2016

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

Authorized official

Name
Lisa Heller, LCSWNPI 1992723977
Title
President
Phone
(260) 437-9022

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community/Behavioral Health Agency 251S00000X 34002636A IN Primary

Addresses

Primary practice location

10315 Dawsons Creek Blvd Ste E
Fort Wayne, IN 46825-1912

Mailing address

10315 Dawsons Creek Blvd Ste E
Fort Wayne, IN 46825-1912
Phone (260) 437-9022

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

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": "1468886400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1468886400000",
    "number": "1972956522",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10315 DAWSONS CREEK BLVD STE E",
            "city": "FORT WAYNE",
            "state": "IN",
            "postal_code": "468251912",
            "telephone_number": "260-437-9022"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10315 DAWSONS CREEK BLVD STE E",
            "city": "FORT WAYNE",
            "state": "IN",
            "postal_code": "468251912",
            "telephone_number": "260-437-9022"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LISA HELLER, LCSW, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-07-19",
        "last_updated": "2016-07-19",
        "status": "A",
        "authorized_official_last_name": "HELLER",
        "authorized_official_first_name": "LISA",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "260-437-9022",
        "authorized_official_credential": "LCSW"
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": "IN",
            "license": "34002636A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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 Jul 19, 2016; 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.