| R P Therapy Llc | |
|
6326 Constitution Dr Fort Wayne IN 46804-1518 | |
| (260) 515-3275 | |
| (888) 803-6843 |
| Full Name | R P Therapy Llc |
|---|---|
| Speciality | Psychologist |
| Location | 6326 Constitution Dr, Fort Wayne, Indiana |
| Authorized Official Name and Position | Chris Fountain (COO) |
| Authorized Official Contact | 2605153275 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| R P Therapy Llc 6326 Constitution Dr Fort Wayne IN 46804-1518 Ph: (260) 515-3275 | R P Therapy Llc 6326 Constitution Dr Fort Wayne IN 46804-1518 Ph: (260) 515-3275 |
| NPI Number | 1912667478 |
|---|---|
| Provider Enumeration Date | 12/26/2021 |
| Last Update Date | 01/11/2022 |
| Certification Date | 01/11/2022 |
| Medicare PECOS PAC ID | 4789076373 |
|---|---|
| Medicare Enrollment ID | O20220111000861 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1912667478 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103T00000X | Psychologist | (* (Not Available)) | Primary |
| Provider Name | Linda L Hartley |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1699707836 PECOS PAC ID: 5890753057 Enrollment ID: I20041221000163 |
| Provider Name | Michael A Ashley |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1801899059 PECOS PAC ID: 2668546045 Enrollment ID: I20081223000023 |
| Provider Name | Stephanie D Rose |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1750743373 PECOS PAC ID: 2567760416 Enrollment ID: I20160411001089 |
| Provider Name | Maria Gootee |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1710330899 PECOS PAC ID: 1052605961 Enrollment ID: I20160815002281 |
| Provider Name | Shawn D Fingerle |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1265880074 PECOS PAC ID: 1850686007 Enrollment ID: I20160826000871 |
| Provider Name | Stephanie Dexter |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1669908109 PECOS PAC ID: 0446537880 Enrollment ID: I20170511002285 |
| Provider Name | Kathryn Lawrence |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1053566182 PECOS PAC ID: 9830575448 Enrollment ID: I20221005002801 |
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