MR. DAVID DOUGLAS THAXTON (NPI# 1548499726) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1548499726 |
| Entity Type | Individual |
| Full Name | MR. DAVID DOUGLAS THAXTON |
| Practice Address |
3010 E State Blvd Fort Wayne IN 46805-4700 |
| Practice Telephone | 2604712300 |
| Practice Fax Number | 2604712778 |
| Mailing Telephone | 2604712300 |
| Mailing Fax Number | 2604712778 |
| Enumeration Date | 2009-07-08 |
| Last Update Date | 2009-07-08 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 101YM0800X |
Counselor Specialization: Mental Health |
Behavioral Health & Social Service Providers |
| Street Address |
3010 E STATE BLVD |
| City | FORT WAYNE |
| State | IN |
| Zip Code | 46805-4700 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1366494031 | Victor K Fitch | Chiropractor | 3010 E State Blvd, Fort Wayne, IN 46805-4700 | 2006-05-17 |
| 1639797699 | Rebecca Ann Bohn | Social Worker | 3010 E State Blvd, Fort Wayne, IN 46805-4700 | 2020-07-07 |
| 1700419744 | Paige Katherine Walker | Social Worker | 3010 E State Blvd, Fort Wayne, IN 46805-4700 | 2020-02-18 |
| 1053839027 | Kerry Lee Mills | Social Worker | 3010 E State Blvd, Fort Wayne, IN 46805-4700 | 2017-08-30 |
| 1649543729 | Shannon Waltersharvey | Counselor | 3010 E State Blvd, Fort Wayne, IN 46805-4700 | 2012-02-20 |
| 1770898744 | Melissa M Koske | Counselor | 3010 E State Blvd, #600, Fort Wayne, IN 46805-4700 | 2010-08-13 |
| 1437387537 | Rita Irene Polivick | Counselor | 3010 E State Blvd, Fort Wayne, IN 46805-4700 | 2009-06-26 |
| 1487881884 | Marilyn Ann Barlag | Social Worker | 3010 E State Blvd, Fort Wayne, IN 46805-4700 | 2009-06-12 |
| 1407003726 | David Allen Vernon Wilson | Counselor | 3010 E State Blvd, Fort Wayne, IN 46805-4700 | 2008-08-19 |
| 1356509467 | Michela Angela Buss | Counselor | 3010 E State Blvd, Fort Wayne, IN 46805-4700 | 2008-05-26 |
| 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 | 101YM0800X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Counselor |
| Specialization | Mental Health |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1548881899 | Emily H Cook | Counselor | 2130 Pemberton Dr, Fort Wayne, IN 46805-4628 | 2020-04-28 |
| 1871113274 | At Your Pace Counseling, LLC | Counselor | 6717 Sky Blue Dr, Fort Wayne, IN 46804-4648 | 2020-04-26 |
| 1962049809 | Lynne Beardsley | Counselor | 4630 W Jefferson Blvd Ste 11, Fort Wayne, IN 46804-6856 | 2019-12-10 |
| 1578108767 | Wholistic Wellness Counseling and Consulting LLC | Counselor | 1129 Rivermet Ave, Fort Wayne, IN 46805-4232 | 2019-11-11 |
| 1922654722 | Nicole Conrad | Counselor | 908 Manck Dr, Fort Wayne, IN 46814-8995 | 2019-08-16 |
| 1336794148 | Healing Through Art | Counselor | 3521 Lake Ave # B1, Fort Wayne, IN 46805-5536 | 2019-08-08 |
| 1013578749 | A.w. Holdings, LLC | Counselor | 3900 Hursh Rd, Fort Wayne, IN 46845-9677 | 2019-06-24 |
| 1811450646 | Living Waters Peace Center | Counselor | 3262 Mallard Cove Ln Ste B, Fort Wayne, IN 46804-2883 | 2019-04-09 |
| 1447718325 | Victoria Lynn Prokop | Counselor | 4656 W Jefferson Blvd Ste 210, Fort Wayne, IN 46804-6884 | 2019-03-09 |
| 1811467632 | Believe Counseling and Consulting | Counselor | 2200 Lake Ave Ste 140, Fort Wayne, IN 46805-5351 | 2018-12-05 |
| Find all providers in FORT WAYNE | ||||
| City | FORT WAYNE |
| Zip Code | 46805 |
Please comment or provide details below to improve the information on MR. DAVID DOUGLAS THAXTON.
| 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.