| A Brighter Future, Llc | |
|
4656 W Jefferson Blvd Ste 285 Fort Wayne IN 46804-6838 | |
| (260) 422-0843 | |
| Not Available |
| Full Name | A Brighter Future, Llc |
|---|---|
| Speciality | Counselor |
| Location | 4656 W Jefferson Blvd Ste 285, Fort Wayne, Indiana |
| Authorized Official Name and Position | Timothy David Theye (PRESIDENT) |
| Authorized Official Contact | 2604506068 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| A Brighter Future, Llc 8228 Victoria Woods Pl Fort Wayne IN 46825-6506 Ph: (260) 450-6068 | A Brighter Future, Llc 4656 W Jefferson Blvd Ste 285 Fort Wayne IN 46804-6838 Ph: (260) 422-0843 |
| NPI Number | 1851672232 |
|---|---|
| Provider Enumeration Date | 08/30/2011 |
| Last Update Date | 08/30/2011 |
| Medicare PECOS PAC ID | 8224202874 |
|---|---|
| Medicare Enrollment ID | O20111117000438 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1851672232 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YP2500X | Counselor - Professional | 34004130A (Indiana) | Primary |
| Provider Name | Timothy D Theye |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1346540556 PECOS PAC ID: 7911819941 Enrollment ID: I20110427000278 |
| Provider Name | Jenny E Seiss |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1861635831 PECOS PAC ID: 1254598410 Enrollment ID: I20120131000803 |
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