| Lutheran Social Services Of Indiana | |
|
333 E Lewis St Fort Wayne IN 46802-3139 | |
| (260) 426-3347 | |
| (260) 426-2248 |
| Full Name | Lutheran Social Services Of Indiana |
|---|---|
| Speciality | Counselor |
| Location | 333 E Lewis St, Fort Wayne, Indiana |
| Authorized Official Name and Position | Angela Moellering (PRESIDENT/CEO) |
| Authorized Official Contact | 2602426633 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Lutheran Social Services Of Indiana 333 E Lewis St Fort Wayne IN 46802-3139 Ph: (260) 426-3347 | Lutheran Social Services Of Indiana 333 E Lewis St Fort Wayne IN 46802-3139 Ph: (260) 426-3347 |
| NPI Number | 1861636136 |
|---|---|
| Provider Enumeration Date | 04/29/2009 |
| Last Update Date | 03/30/2022 |
| Certification Date | 03/30/2022 |
| Medicare PECOS PAC ID | 7416344262 |
|---|---|
| Medicare Enrollment ID | O20220425001958 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1861636136 | NPI | - | NPPES |
| 200072230 | Medicaid | IN |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101Y00000X | Counselor | (* (Not Available)) | Primary |
| Provider Name | Amy L Drake |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1508172180 PECOS PAC ID: 3779740774 Enrollment ID: I20120202000542 |
| Provider Name | Toni Lovell |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1467059907 PECOS PAC ID: 4587051339 Enrollment ID: I20220425002020 |
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