MIDWEST ADDICTION PSYCHIATRIC & PSYCHOLOGICAL SERVICES LLC NPI 1336190149

NPI Information

NPI: 1336190149
Provider Name: MIDWEST ADDICTION PSYCHIATRIC & PSYCHOLOGICAL SERVICES LLC

Doing Business As: MAPPS

Classification: Counselor - 101YA0400X
Entity Type: Organization

Specialization: Addiction (Substance Use Disorder)

Address:
3010 E. STATE BLVD
STE 100
FORT WAYNE, IN
ZIP 46805
Phone: (260) 471-0632
Get Directions

MIDWEST ADDICTION PSYCHIATRIC & PSYCHOLOGICAL SERVICES LLC is an addiction (substance use disorder) counselor in Fort Wayne, IN. MIDWEST ADDICTION PSYCHIATRIC & PSYCHOLOGICAL SERVICES LLC NPI is 1336190149. The provider is registered as an organization entity type and is a multi-specialty group.
The provider Is Doing Business As Mapps.

The provider's business location address is:

3010 E. STATE BLVD
STE 100
FORT WAYNE, IN
ZIP 46805
Phone: (260) 471-0632
Fax: (260) 471-3451

The provider's authorized official is Don A Marshall .
The authorized official title is Owner and has the following contact phone number (260) 456-7261.

The enumeration date for this NPI number is 5/15/2006 and was last updated on 3/2/2018.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	101YA0400X	Counselor	Addiction (Substance Use Disorder)	14060ASO	INDIANA	Yes
2	101YM0800X	Counselor	Mental Health	14060ASO	INDIANA	No
3	103T00000X	Psychologist		14060ASO	INDIANA	No
4	103TA0400X	Psychologist	Addiction (Substance Use Disorder)	14060ASO	INDIANA	No
5	103TB0200X	Psychologist	Cognitive & Behavioral	14060ASO	INDIANA	No
6	103TC2200X	Psychologist	Clinical Child & Adolescent	14060ASO	INDIANA	No
7	103TF0200X	Psychologist	Forensic	14060ASO	INDIANA	No
8	1041C0700X	Social Worker	Clinical	14060ASO	INDIANA	No
9	106H00000X	Marriage & Family Therapist		14060ASO	INDIANA	No
10	2084P0800X	Psychiatry & Neurology	Psychiatry	14060ASO	INDIANA	No
11	2084P0802X	Psychiatry & Neurology	Addiction Psychiatry	14060ASO	INDIANA	No

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	200200260A	MEDICAID	INDIANA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/14/2023

NPI Synchronization or Removal

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