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NPI Code Detail

MEDICARE: AMY SORDELET

MEDICARE:   AMY  SORDELET
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
1101YM0800XMental Health Counselor39005103AIN

General Provider Information

NPI Number : 1396694170
Entity Type Code : Individual
Provider Name (Legal Business Name) : AMY SORDELET
Provider Business Mailing Address
First Line : 317 LEXINGTON CT
Second Line :
City : FORT WAYNE
State : IN
Zip : 46806-1745
Country : US
Telephone Number : 260-341-9199
Fax Number :
Provider Business Practice Location Address
First Line : 3601 HOBSON RD STE 203
Second Line :
City : FORT WAYNE
State : IN
Zip : 46815-4527
Country : US
Telephone Number : 260-433-7635
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/26/2026
Last Update Date : 01/26/2026

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Directions to “ AMY SORDELET ” Practice Location

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