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NPI Code Detail

MEDICARE: MR. DENNIS LEE HOWARD MA

MEDICARE: MR. DENNIS LEE HOWARD MA
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1101Y00000XCounselor35000317AIN
2101YM0800XMental Health Counselor39001368AIN
31041C0700XClinical Social Worker35000317AIN

General Provider Information

NPI Number : 1124036405
Entity Type Code : Individual
Provider Name (Legal Business Name) : MR. DENNIS LEE HOWARD MA
Provider Business Mailing Address
First Line : 4004 NOTTINGHAM DR
Second Line :
City : FORT WAYNE
State : IN
Zip : 46815-5536
Country : US
Telephone Number : 260-471-1950
Fax Number : 260-471-1950
Provider Business Practice Location Address
First Line : 2821 HILLEGAS RD
Second Line :
City : FORT WAYNE
State : IN
Zip : 46808-3859
Country : US
Telephone Number : 260-471-1950
Fax Number : 260-471-1950
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/03/2006
Last Update Date : 02/07/2008

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