Fort Wayne Neuropsychology Llc - Medicare Mental Health Clinic in Fort Wayne, IN

Fort Wayne Neuropsychology Llc is a medicare enrolled mental health clinic (Clinical Neuropsychologist) in Fort Wayne, Indiana. The current practice location for Fort Wayne Neuropsychology Llc is 4306 E State Blvd, Fort Wayne, Indiana. For appointments, you can reach them via phone at (260) 460-3100. The mailing address for Fort Wayne Neuropsychology Llc is 4306 E State Blvd, Fort Wayne, Indiana and phone number is () -.

Fort Wayne Neuropsychology Llc is licensed to practice in * (Not Available) (license number ). The clinic also participates in the medicare program and its NPI number is 1871032862. This medical practice accepts medicare insurance (which means this clinic accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance). However, please confirm if they accept your insurance at (260) 460-3100.

Contact Information

Fort Wayne Neuropsychology Llc
4306 E State Blvd
Fort Wayne
IN 46815-6915
(260) 460-3100
Not Available

Map and Direction


Mental Health Clinic Profile

Full NameFort Wayne Neuropsychology Llc
SpecialityClinical Neuropsychologist
Location4306 E State Blvd, Fort Wayne, Indiana
Authorized Official Name and PositionTasha H. Williams (VICE PRESIDENT)
Authorized Official Contact2604148629
Accepts Medicare InsuranceYes. This clinic participates in medicare program and accept medicare insurance.

Mailing Address and Practice Location

Mailing AddressPractice Location Address
Fort Wayne Neuropsychology Llc
4306 E State Blvd
Fort Wayne
IN 46815-6915

Ph: () -
Fort Wayne Neuropsychology Llc
4306 E State Blvd
Fort Wayne
IN 46815-6915

Ph: (260) 460-3100

NPI Details:

NPI Number1871032862
Provider Enumeration Date02/23/2017
Last Update Date02/23/2017

Medicare PECOS Information:

Medicare PECOS PAC ID0345526893
Medicare Enrollment IDO20170417001683

Medical Identifiers

Medical identifiers for Fort Wayne Neuropsychology Llc such as npi, medicare ID, medicare PIN, medicaid, etc.
IdentifierTypeStateIssuer
1871032862NPI-NPPES

Medical Taxonomies and Licenses

TaxonomyTypeLicense (State)Status
103G00000XClinical Neuropsychologist (* (Not Available))Primary
103T00000XPsychologist (* (Not Available))Secondary
1041C0700XSocial Worker - Clinical (* (Not Available))Secondary

Medicare Reassignments

Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works. Fort Wayne Neuropsychology Llc acts as a billing entity for following providers:
Provider NameTasha H Williams
Provider TypePractitioner - Clinical Psychologist
Provider IdentifiersNPI Number: 1467499780
PECOS PAC ID: 9931106093
Enrollment ID: I20061102000263
Provider NameMargaret L Jones
Provider TypePractitioner - Clinical Social Worker
Provider IdentifiersNPI Number: 1396850236
PECOS PAC ID: 5496756595
Enrollment ID: I20070116000183
Provider NamePeter Dodzik
Provider TypePractitioner - Clinical Psychologist
Provider IdentifiersNPI Number: 1437156999
PECOS PAC ID: 8224110275
Enrollment ID: I20080129000646
Provider NameJacob T Lutz
Provider TypePractitioner - Clinical Psychologist
Provider IdentifiersNPI Number: 1164860052
PECOS PAC ID: 6901040138
Enrollment ID: I20130910000253
Provider NameErin M Miles
Provider TypePractitioner - Clinical Psychologist
Provider IdentifiersNPI Number: 1699196519
PECOS PAC ID: 0446480784
Enrollment ID: I20140305001572
Provider NameKelly L Hoover
Provider TypePractitioner - Clinical Psychologist
Provider IdentifiersNPI Number: 1447891312
PECOS PAC ID: 0042541344
Enrollment ID: I20191018000065
Provider NameLori Stock
Provider TypePractitioner - Clinical Social Worker
Provider IdentifiersNPI Number: 1255974804
PECOS PAC ID: 3870925431
Enrollment ID: I20191120000610
Provider NameCynthia L Shepherd
Provider TypePractitioner - Qualified Speech Language Pathologist
Provider IdentifiersNPI Number: 1689899486
PECOS PAC ID: 7416385885
Enrollment ID: I20200318000447
Provider NameCatherine M Short
Provider TypePractitioner - Clinical Psychologist
Provider IdentifiersNPI Number: 1912686627
PECOS PAC ID: 9537521752
Enrollment ID: I20230818001972

Reviews and Comments

Clinical Neuropsychologist in Fort Wayne, IN

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Medicare Assignment: Assignment means that your doctor, provider, or supplier agrees (or is required by law) to accept the Medicare-approved amount as full payment for covered services. Most doctors, providers, and suppliers accept assignment, but you should always check to make sure. Participating providers have signed an agreement to accept assignment for all Medicare-covered services.

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