Healthcare Provider Details

I. General information

NPI: 1841126299
Provider Name (Legal Business Name): ADAM GAYER LMHC
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/23/2026
Last Update Date: 06/23/2026
Certification Date: 06/23/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4656 W JEFFERSON BLVD STE 285
FORT WAYNE IN
46804-6838
US

IV. Provider business mailing address

855 WEBSTER ST UNIT 807
FORT WAYNE IN
46802-2256
US

V. Phone/Fax

Practice location:
  • Phone: 260-409-5544
  • Fax:
Mailing address:
  • Phone: 260-409-5544
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number39006029A
License Number StateIN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: