| Cns | |
|
3010 E State Blvd Fort Wayne IN 46805 | |
| (260) 471-2300 | |
| (260) 471-2778 |
| Full Name | Cns |
|---|---|
| Speciality | Clinic/Center |
| Location | 3010 E State Blvd, Fort Wayne, Indiana |
| Authorized Official Name and Position | Barbara C Gelder (OWNER PSYCHOLOGIST) |
| Authorized Official Contact | 2604712300 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Cns 3010 E State Blvd Fort Wayne IN 46805 Ph: (260) 471-2300 | Cns 3010 E State Blvd Fort Wayne IN 46805 Ph: (260) 471-2300 |
| NPI Number | 1548275258 |
|---|---|
| Provider Enumeration Date | 07/30/2006 |
| Last Update Date | 05/05/2022 |
| Certification Date | 05/05/2022 |
| Medicare PECOS PAC ID | 3072544584 |
|---|---|
| Medicare Enrollment ID | O20050824000934 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1548275258 | NPI | - | NPPES |
| 200250010A | Medicaid | IN | |
| 2464293 | Other | OH | MEDICAID |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0801X | Clinic/center - Mental Health (including Community Mental Health Center) | (* (Not Available)) | Primary |
| Provider Name | Barbara C Gelder |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1447265152 PECOS PAC ID: 5597796011 Enrollment ID: I20050824001022 |
| Provider Name | Michele L Viers |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1639637341 PECOS PAC ID: 6709114127 Enrollment ID: I20190823000203 |
| Provider Name | Sylvia A Manalis |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1972572287 PECOS PAC ID: 2769818178 Enrollment ID: I20200203002458 |
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