Amanda M Wyatt, LCSW | |
2700 Lafayette St, Fort Wayne, IN 46806-1100 | |
(260) 481-2770 | |
(260) 481-2771 |
Full Name | Amanda M Wyatt |
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Gender | Female |
Speciality | Social Worker - Clinical |
Location | 2700 Lafayette St, Fort Wayne, Indiana |
Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1811349335 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
1041C0700X | Social Worker - Clinical | 34008266A (Indiana) | Primary |
Entity Name | Park Center Inc |
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Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1306897004 PECOS PAC ID: 5991794794 Enrollment ID: O20041213000226 |
Mailing Address | Practice Location Address |
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Amanda M Wyatt, LCSW 11109 Parkview Plaza Dr # 117, Fort Wayne, IN 46845-1701 Ph: () - | Amanda M Wyatt, LCSW 2700 Lafayette St, Fort Wayne, IN 46806-1100 Ph: (260) 481-2770 |
Alia Osborn, MSW Clinical Social Worker Medicare: Not Enrolled in Medicare Practice Location: 6526 Hillsboro Ln, Fort Wayne, IN 46835 Phone: 260-494-2205 | |
Nicholas Todoran, MSW Clinical Social Worker Medicare: Accepting Medicare Assignments Practice Location: 1909 Carew St, Fort Wayne, IN 46805 Phone: 260-481-2800 Fax: 260-969-8442 | |
Jeri Ann Forrest, LCSW Clinical Social Worker Medicare: Not Enrolled in Medicare Practice Location: 1818 Carew St, Suite 230, Fort Wayne, IN 46805 Phone: 260-373-8000 Fax: 260-373-8003 | |
Rikki Lynn Treesh, MSW Clinical Social Worker Medicare: Medicare Enrolled Practice Location: 4918 Canterbury Dr, Fort Wayne, IN 46835 Phone: 260-241-6191 | |
Ms. Yvonne Smith, LCSW Clinical Social Worker Medicare: Not Enrolled in Medicare Practice Location: 3262 Mallard Cove Ln, Fort Wayne, IN 46804 Phone: 260-580-8508 Fax: 260-755-1451 | |
Deborah Louise Amick, L.C.S.W. Clinical Social Worker Medicare: Not Enrolled in Medicare Practice Location: 12333 Southampton Dr, Fort Wayne, IN 46814 Phone: 260-672-0491 | |
Scott Kruse, Clinical Social Worker Medicare: Not Enrolled in Medicare Practice Location: 2121 Lake Ave, Fort Wayne, IN 46805 Phone: 260-426-5431 Fax: 260-421-1029 |