MEDICARE: CONNECTION POINTS INC.

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
1	101YP1600X	Pastoral Counselor
2	101YA0400X	Addiction (Substance Use Disorder) Counselor

General Provider Information

NPI Number	:	1871172478
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CONNECTION POINTS INC.

Provider Business Mailing Address
First Line	:	2112 INWOOD DR
Second Line	:
City	:	FORT WAYNE
State	:	IN
Zip	:	46815-7115
Country	:	US
Telephone Number	:	260-218-8299
Fax Number	:

Provider Business Practice Location Address
First Line	:	2112 INWOOD DR
Second Line	:
City	:	FORT WAYNE
State	:	IN
Zip	:	46815-7115
Country	:	US
Telephone Number	:	260-218-8299
Fax Number	:

Authorized Official
Title or Position	:	EXECUTIVE DIRECTOR
Name	:	DANIEL D SCHRECK
Credential	:	PHD
Telephone Number	:	260-218-8299

Provider Enumeration Date	:	04/02/2021
Last Update Date	:	04/02/2021

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