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LIVING WATERS PEACE CENTER NPI 1811450646


NPI Information

NPI: 1811450646
Provider Name: LIVING WATERS PEACE CENTER
Classification: Counselor - 101YM0800X
Entity Type: Organization

Specialization: Mental Health

Address:
3262 MALLARD COVE LN STE B
FORT WAYNE, IN
ZIP 46804
Phone: (260) 230-1180
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LIVING WATERS PEACE CENTER is a mental health counselor in Fort Wayne, IN. LIVING WATERS PEACE CENTER NPI is 1811450646. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

3262 MALLARD COVE LN STE B
FORT WAYNE, IN
ZIP 46804-883
Phone: (260) 230-1180

The provider's authorized official is Tracy Lynn Cain .
The authorized official title is Owner/mental Health Counselor Assoc and has the following contact phone number (260) 230-1180.

The enumeration date for this NPI number is 4/9/2019 and was last updated on 4/9/2019.


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 CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1101YM0800XCounselorMental HealthYes

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

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.