MS. NICOLE MARIE GAUNT (NPI# 1326683228) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1326683228 |
| Entity Type | Individual |
| Full Name | MS. NICOLE MARIE GAUNT |
| Credential | LCSW |
| Practice Address |
2200 Randallia Dr Fort Wayne IN 46805-4638 |
| Mailing Address |
3702 New Vision Dr Bldg B Fort Wayne IN 46845-1703 |
| Practice Telephone | 2603738000 |
| Practice Fax Number | 2603738034 |
| Enumeration Date | 2019-11-14 |
| Last Update Date | 2020-01-16 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1041C0700X |
Social Worker Specialization: Clinical |
34008302A | IN | Behavioral Health & Social Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| IN | LCSW LICENSE | 34008302A | 01 |
| IN | 34008302A | 05 |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 3010 E State Blvd, Fort Wayne, IN 468054700 | 2604712300 |
| Street Address |
2200 RANDALLIA DR |
| City | FORT WAYNE |
| State | IN |
| Zip Code | 46805-4638 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1972508471 | Matthew Paul Ziccardi | Clinical Neuropsychologist | 2200 Randallia Dr, Fort Wayne, IN 46805 | 2005-06-20 |
| 1891308896 | Cameron Buzzard | Physical Therapist | 2200 Randallia Dr, Fort Wayne, IN 46805-4638 | 2020-08-28 |
| 1558985945 | Morgan Taylor Hilbert | Pharmacist | 2200 Randallia Dr, Fort Wayne, IN 46805-4638 | 2020-06-02 |
| 1952941908 | Lydia Hentz | Counselor | 2200 Randallia Dr, Fort Wayne, IN 46805-4638 | 2020-01-07 |
| 1205490877 | Elisha Lynn Handshoe | Physical Medicine & Rehabilitation | 2200 Randallia Dr, Fort Wayne, IN 46805-4638 | 2019-04-29 |
| 1154884898 | Monique Brissette | Speech-Language Pathologist | 2200 Randallia Dr, Fort Wayne, IN 46805-4638 | 2019-04-10 |
| 1649733411 | Clarissa Burkett | Physical Therapy Assistant | 2200 Randallia Dr, Fort Wayne, IN 46805-4638 | 2019-04-09 |
| 1740743533 | Ross Tyler Nelson | Physical Therapist | 2200 Randallia Dr, Fort Wayne, IN 46805-4638 | 2019-04-09 |
| 1295298982 | Jennifer Ferguson | Occupational Therapist | 2200 Randallia Dr, Fort Wayne, IN 46805-4638 | 2019-04-09 |
| 1336602390 | Rachel Thompson | Pharmacist | 2200 Randallia Dr, Fort Wayne, IN 46805-4638 | 2019-04-08 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1619589546 | Connor Gemlick | Student in an Organized Health Care Education/Training Program | 1918 Carew St., Fort Wayne, IN 46805 | 2020-08-21 |
| 1710464086 | S.t.a.r. Care Services | Clinic/Center | 3521 Lake Avenue, Suite #4, Fort Wayne, IN 46805 | 2018-07-19 |
| 1083122865 | Noel Shafi | Counselor | 3010 East State Boulevard, Fort Wayne, IN 46805 | 2018-01-16 |
| 1063963627 | Toni L Irby | Specialist | 3219 E State Blvd, Fort Wayne, IN 46805 | 2016-10-19 |
| 1639626211 | Logan Schwerer | Pharmacist | 923 Northcrest Business Center 6d, Fort Wayne, IN 46805 | 2016-09-01 |
| 1063817104 | Michale Diane Rothgeb | Physical Therapy Assistant | 2200 Randollia Dr, Fort Wayne, IN 46805 | 2014-10-31 |
| 1124435789 | Julia I. Mcfann | Physical Therapist | 2200 Randalia Dr, Fort Wayne, IN 46805 | 2014-07-16 |
| 1083036974 | Capital Senior Living Properties 4, Inc. | Assisted Living Facility | 3320 East State Boulevard, Fort Wayne, IN 46805 | 2014-01-10 |
| 1356772396 | Alexander James Medical Supply | Durable Medical Equipment & Medical Supplies | 2200 Lake Avenue, Suite 290, Fort Wayne, IN 46805 | 2013-12-02 |
| 1043595689 | Randy James Jennings | Pharmacist | 923 Northcrest Business Center, 6-d, Fort Wayne, IN 46805 | 2011-10-14 |
| Find all providers in zip 46805 | ||||
| Taxonomy Code | 1041C0700X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Social Worker |
| Specialization | Clinical |
| A social worker who holds a master’s or doctoral degree in social work from an accredited school of social work in addition to at least two years of post-master’s supervised experience in a clinical setting. The social worker must be licensed, certified, or registered at the clinical level in the jurisdiction of practice. A clinical social worker provides direct services, including interventions focused on interpersonal interactions, intrapsychic dynamics, and life management issues. Clinical social work services are based on bio-psychosocial perspectives. Services consist of assessment, diagnosis, treatment (including psychotherapy and counseling), client-centered advocacy, consultation, evaluation, and prevention of mental illness, emotional, or behavioral disturbances. |
| Notes: Source: National Association of Social Workers, 2008 [7/1/2009: definition modified] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1154933299 | Kristina Lynn Devors | Social Worker | 7116 Chippenham Dr, Fort Wayne, IN 46818-0033 | 2020-08-19 |
| 1023636909 | Gary Scott Ralya | Social Worker | 2121 E State Blvd, Fort Wayne, IN 46805-4640 | 2020-07-08 |
| 1003444985 | Courageous Healing Inc | Social Worker | 2013 S Anthony Blvd, Fort Wayne, IN 46803-3609 | 2020-03-27 |
| 1164060653 | Brosh Inc | Social Worker | 4820 Oak Knob Run, Fort Wayne, IN 46845-8939 | 2019-12-15 |
| 1740780204 | Jay Bastian LLC | Social Worker | 9910 Dupont Circle Dr. Suite 140, Fort Wayne, IN 46825-1610 | 2018-02-20 |
| 1790291755 | Resolutions Counseling LLC | Social Worker | 13207 Hammerhill Way, Fort Wayne, IN 46845-2351 | 2017-12-28 |
| 1295256907 | Kimberly Ann Bailey | Social Worker | 5310 Merchandise Dr., Fort Wayne, IN 46814 | 2017-07-03 |
| 1306377304 | Charla Leman | Social Worker | 8011 Basswood Pl, Fort Wayne, IN 46835-4752 | 2017-03-22 |
| 1659826055 | Frank Deisler | Social Worker | 5543 S Wayne Ave, Fort Wayne, IN 46807-3128 | 2016-08-16 |
| 1013376458 | Rikki Lynn Treesh | Social Worker | 4918 Canterbury Dr, Fort Wayne, IN 46835-4102 | 2016-02-13 |
| Find all providers in FORT WAYNE | ||||
| City | FORT WAYNE |
| Zip Code | 46805 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.