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General NPI Number Information
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NPI Number | 1396694170
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Entity Type | Individual
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Provider Name | AMY SORDELET
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Gender | Female
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Dates
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Enumeration Date | 01/26/2026
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Last Update Date | 01/26/2026
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Provider Practice Location Address
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Address Line | 3601 HOBSON RD STE 203
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City | FORT WAYNE
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State | IN
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Zip | 46815-4527
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Country | US
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Telephone | 260-433-7635
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Fax |
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Provider Business Mailing Address
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Address Line | 317 LEXINGTON CT
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City | FORT WAYNE
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State | IN
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Zip | 46806-1745
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Country | US
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Telephone | 260-341-9199
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | 39005103A
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License Number State | IN
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