Lydia Hentz, | |
2200 Randallia Dr, Fort Wayne, IN 46805-4638 | |
(260) 373-8000 | |
(260) 373-8034 |
Full Name | Lydia Hentz |
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Gender | Female |
Speciality | Counselor - Mental Health |
Location | 2200 Randallia Dr, 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 |
---|---|---|---|
1952941908 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
101YM0800X | Counselor - Mental Health | 39003477A (Indiana) | Primary |
Entity Name | Parkview Health System Inc |
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Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1932130952 PECOS PAC ID: 2163336967 Enrollment ID: O20031117000288 |
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 |
---|---|
Lydia Hentz, 11109 Parkview Plaza Dr # 117, Fort Wayne, IN 46845-1701 Ph: () - | Lydia Hentz, 2200 Randallia Dr, Fort Wayne, IN 46805-4638 Ph: (260) 373-8000 |
Courtney Lesley Washington, Counselor Medicare: Accepting Medicare Assignments Practice Location: 909 E State Blvd, Fort Wayne, IN 46805 Phone: 260-481-2700 | |
Alicia Jean Digiulio, MA, MSED, LMHC Counselor Medicare: Not Enrolled in Medicare Practice Location: 9417 Saint Joe Center Rd, Fort Wayne, IN 46835 Phone: 260-255-5289 | |
Jennifer Perry, MS Counselor Medicare: Not Enrolled in Medicare Practice Location: 909 E State Blvd, Fort Wayne, IN 46805 Phone: 260-481-2700 Fax: 260-481-2709 | |
Raphilla D Dixie, Counselor Medicare: Medicare Enrolled Practice Location: 3005 E State Blvd, Fort Wayne, IN 46805 Phone: 260-267-9498 Fax: 260-739-3618 | |
Timothy Jay Hill, MSED Counselor Medicare: Not Enrolled in Medicare Practice Location: 2100 Goshen Rd, Fort Wayne, IN 46808 Phone: 260-471-3500 | |
Rita Kay Self, M.S. Counselor Medicare: Not Enrolled in Medicare Practice Location: 3010 E State Blvd, Fort Wayne, IN 46805 Phone: 260-471-2300 Fax: 260-471-2778 | |
Rachida Bejja, MSED, LMHC Counselor Medicare: Not Enrolled in Medicare Practice Location: 10828 Coldwater Rd, Fort Wayne, IN 46845 Phone: 260-415-8267 Fax: 260-426-0270 |