ERICA L WALWORTH (NPI# 1336255801) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1336255801 |
| Entity Type | Individual |
| Full Name | ERICA L WALWORTH |
| Credential | MS LMFT CEDS RDN LD |
| Practice Address |
412 S Scott Rd Fort Wayne IN 46814 |
| Mailing Address |
11330 Eagle Crest Trl Fort Wayne IN 46845-1186 |
| Practice Telephone | 2603587180 |
| Mailing Telephone | 2604899009 |
| Mailing Fax Number | 2604895057 |
| Enumeration Date | 2006-08-21 |
| Last Update Date | 2019-08-15 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 106H00000X | Marriage & Family Therapist | 35001890A | IN | Behavioral Health & Social Service Providers |
| N | 133V00000X | Dietitian, Registered | 37001673A | IN | Dietary & Nutritional Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| CDR | 893263 | 01 | |
| AMERICAN DIETETIC ASSOCIA | 0893263 | 01 |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 4210 Flagstaff Cv, Fort Wayne, IN 468154417 | 2604899009 | 2604895057 |
| Street Address |
412 S SCOTT RD |
| City | FORT WAYNE |
| State | IN |
| Zip Code | 46814 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1881203636 | Claire Moorman | Dietitian, Registered | 412 S Scott Rd, Fort Wayne, IN 46814-9702 | 2020-07-28 |
| 1295396810 | Neossia Inc | Clinic/Center | 412 S Scott Rd, Fort Wayne, IN 46814 | 2019-06-25 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1295256907 | Kimberly Ann Bailey | Social Worker | 5310 Merchandise Dr., Fort Wayne, IN 46814 | 2017-07-03 |
| 1821229998 | Back In Action Chiropractic | Chiropractor | 10443 Llinois Road, Fort Wayne, IN 46814 | 2009-08-06 |
| 1376789420 | Richard Frederick Fox | Radiology | 6226 Devils Hollow Rd., Fort Wayne, IN 46814 | 2008-12-19 |
| 1225287998 | George W. Bowers | Urology | 12002 Haddington Court, Fort Wayne, IN 46814 | 2008-09-17 |
| 1588831986 | Xue Zhang | Family Medicine | 10515 Illimois Rd, Fort Wayne, IN 46814 | 2008-05-14 |
| 1245449172 | Charles S Lindzy | Anesthesiology | 14104 Peddlers Ford, Fort Wayne, IN 46814 | 2007-05-21 |
| 1043338999 | Aboite Township Fire Dept In | Ambulance | 11321 Aboite Center Rd, Fort Wayne, IN 46814 | 2007-03-27 |
| 1588748206 | Lisa Renee Vachon | Chiropractor | 971 Chestnut Hills Pkwy, Ft Wayne, IN 46814 | 2006-10-25 |
| 1962586685 | Daniel Vern Velliquette | Chiropractor | 971 Chestnut Hills Parkway, Fort Wayne, IN 46814 | 2006-10-25 |
| 1619940970 | Shobana Pandian | Pediatrics | 10515 Illinois Rd, Fort Wayne, IN 46814 | 2006-02-08 |
| Find all providers in zip 46814 | ||||
| Taxonomy Code | 106H00000X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Marriage & Family Therapist |
| A marriage and family therapist is a person with a master's degree in marriage and family therapy, or a master's or doctoral degree in a related mental health field with substantially equivalent coursework in marriage and family therapy, who receives supervised clinical experience, or a person who meets the state requirements to practice as a marriage and family therapist. A marriage and family therapist treats mental and emotional disorders within the context of marriage and family systems. A marriage and family therapist provides mental health and counseling services to individuals, couples, families, and groups. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1487287371 | Fort Wayne Counseling Services | Marriage & Family Therapist | 6319 Mutual Dr Ste F, Fort Wayne, IN 46825-4246 | 2020-02-19 |
| 1942701214 | Joshawa Todd Torres | Marriage & Family Therapist | 5651 Coventry Ln # 116, Fort Wayne, IN 46804 | 2018-02-22 |
| 1922497775 | Mary Lisa Barta LLC | Marriage & Family Therapist | 5630 The Prophets Pass, Fort Wayne, IN 46845-9473 | 2015-01-16 |
| 1548506728 | Carmella Nicole Oneal | Marriage & Family Therapist | 4630 W Jefferson Blvd Ste 3, Fort Wayne, IN 46804-6800 | 2012-12-17 |
| 1962754523 | Matt Ryan Givens | Marriage & Family Therapist | 237 Airport North Office Park, Fort Wayne, IN 46825-6702 | 2012-10-08 |
| 1083988547 | Glenis A Sundberg | Marriage & Family Therapist | 1818 Carew St Ste 320, Fort Wayne, IN 46805-4764 | 2012-03-01 |
| 1982982898 | Ferraro Behavior Services, LLC | Marriage & Family Therapist | 9512 Lima Rd Ste 103, Fort Wayne, IN 46818-9806 | 2011-07-26 |
| 1679870646 | Stephen Michael O'shaughnessy | Marriage & Family Therapist | 3407 Rolston St, Fort Wayne, IN 46805-1535 | 2011-02-27 |
| 1760711808 | Marjorie L Havens | Marriage & Family Therapist | 2330 Beacon St, Suite 105, Fort Wayne, IN 46805-3852 | 2009-12-21 |
| 1366673956 | Melissa Ann Borton | Marriage & Family Therapist | 126 W Columbia St, Ste 300, Fort Wayne, IN 46802-1719 | 2009-07-31 |
| Find all providers in FORT WAYNE | ||||
| City | FORT WAYNE |
| Zip Code | 46814 |
Please comment or provide details below to improve the information on ERICA L WALWORTH.
| 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.