Unknown Individual – Community Psychiatric/Mental Health Clinical Nurse Specialist, NPI 1952378895

Community Psychiatric/Mental Health Clinical Nurse Specialist

Unknown Individual is a healthcare provider. based in Fort wayne, Indiana. specializing in Community Psychiatric/Mental Health Clinical Nurse Specialist. They hold a License No. 70000031A (IN). The NPI Number for Unknown Individual is 1952378895

Main info

Organization

Inactive

48 Years Of Experience

Accepts Medicare Assignment

Name

Unknown Individual

NPI

1952378895

Phone

(260) 481-2700

Address

909 E STATE BLVD

Deactivation Date

31 July 2024

Doctor Profile

Medical School Name

OTHER

Secondary Phone

2604812718

Graduation Year

1978 (48 years ago)

PAC ID

8527198597

Group Practice PAC ID

5991794794

Professional Enrollment ID

I20100617000839

Data current as of

19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology

Experience14

Completeness75

Years active:0State licenses:1Digital endpointsOther names

Loading map...

Provider Addresses for Unknown Individual

909, East State Boulevard, Fort Wayne, Allen County, Indiana, 46805, United States
FORT WAYNE, IN 468053404
Phone: (260) 481-2700
Fax: (260) 481-2717
Mailing address matches the actual address.

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

Loading prescription activity...

Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

No Medicare enrollment or revalidation data available for this provider in our database.

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 46805)

Loading plans...

Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.

PAC ID: 5991794794View full group profile

Name	Specialty	State
TAYLOR DAWN SAUNDERS	Mental Health Counselor	IN
MARJORIE L BURNS (LCSW, MSSW)	Clinical Social Worker	IN
MELODIE A GAVIN (RN)	Nurse Practitioner	IN
BRYAN WILLIAM SMITH (LMFT)	Marriage And Family Therapist	IN
TIMOTHY B KOWALESKI (DO)	Family Practice	IN
VALERIE RUNYON (BS)	-	IN
MELISSA ANN TERRY (APN)	-	IN
RICHARD L. HITE (PH.D., HSPP)	-	IN
JANET BAKER ANDERSON (RN FNP)	Nurse Practitioner	IN
HEATHER SEEWALD (MS)	Mental Health Counselor	IN

Reviews

All reviews are moderated before publication. Reviews reflect users' opinions; we do not verify the accuracy of individual reviews.

No reviews yet. Be the first to share your experience — your opinion helps families compare providers.

Frequently asked questions

What unique ID ties claims to Unknown Individual?

NPI 1952378895 is assigned to Unknown Individual under the national enumeration system.

Is Unknown Individual's inactive status permanent?

An inactive NPI does not by itself prove someone stopped practicing — check other sources.

What field does Unknown Individual work in?

You can think of Unknown Individual as practicing within Community Psychiatric/Mental Health Clinical Nurse Specialist. Clinical services aligned with this taxonomy classification.

What location metadata exists for Unknown Individual?

The page summarizes Fort Wayne, Indiana for Unknown Individual; expand the address list for detail.

Is this NPI for an individual or an organization?

This listing corresponds to an Individual Provider.