JAY BASTIAN LLC (NPI# 1740780204) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1740780204 |
| Entity Type | Organization |
| Organization Name | JAY BASTIAN LLC |
| Practice Address |
9910 Dupont Circle Dr. Suite 140 Fort Wayne IN 46825-1610 |
| Practice Telephone | 2605704515 |
| Practice Fax Number | 2602090762 |
| Mailing Telephone | 2605704515 |
| Mailing Fax Number | 2602090762 |
| Enumeration Date | 2018-02-20 |
| Last Update Date | 2018-02-20 |
| Authorized Official Name | MR. JAY ALAN BASTIAN (PSYCHOTHERAPIST) |
| Authorized Official Telephone | 2605704515 |
| Authorized Official Credential | LCSW |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1041C0700X |
Social Worker Specialization: Clinical |
34007970A | IN | Behavioral Health & Social Service Providers |
| Street Address |
9910 DUPONT CIRCLE DR. SUITE 140 |
| City | FORT WAYNE |
| State | IN |
| Zip Code | 46825-1610 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1336772078 | Bradley Murphy | Occupational Therapist | 2626 St Joe Center Ed, Fort Wayne, IN 46825 | 2020-02-21 |
| 1144851015 | Sabryna Roman | Developmental Therapist | 2626 St Joe Center Rd, Fort Wayne, IN 46825 | 2020-01-30 |
| 1205474103 | Ashleigh Miller | Developmental Therapist | 2626 St. Joe Center Rd, Fort Wayne, IN 46825 | 2019-12-11 |
| 1962055152 | Carehalo Ohio LLC | General Practice | 2510 Dupont Circle Dr., Suite 201, Fort Wayne, IN 46825 | 2019-07-17 |
| 1306318175 | Logan Alan Williams | Nurse Anesthetist, Certified Registered | 10315 Dawsons Creek Blvd Ste B, Fort Wayne, IN 46825 | 2018-12-18 |
| 1326582925 | Mark F Stoner LLC | Dentist | 9830 Auburn Rd Suite 102, Fort Wayne, IN 46825 | 2016-12-15 |
| 1336695782 | Nadine Rene' Handy | Nurse Practitioner | 3978 New Vision Dr., Fort Wayne, IN 46825 | 2016-08-26 |
| 1558815712 | Nathan Paul Miller | Physical Therapist | 10006 Auburn Park Dr, Fort Wayne, IN 46825 | 2016-08-05 |
| 1013366905 | Brianna Abbott | Physician Assistant | 1234 E Dupont Rd Ste 7, Fort Wayne, IN 46825 | 2016-06-10 |
| 1003276643 | Seiss, LLC | Psychologist | 9910 Dupont Circle Drive, Suite 140, Fort Wayne, IN 46825 | 2016-02-24 |
| Find all providers in zip 46825 | ||||
| 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 |
| 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 |
| 1083072128 | Joy Nagel | Social Worker | 2105 Point West Dr Apt 1d, Fort Wayne, IN 46808-4308 | 2016-02-03 |
| Find all providers in FORT WAYNE | ||||
| City | FORT WAYNE |
| Zip Code | 46825 |
Please comment or provide details below to improve the information on JAY BASTIAN LLC.
| 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.