MEDICARE: MRS. SUSAN MARIE TIELKER-SHARPE LCSW LMFT ACSW

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	106H00000X	Marriage & Family Therapist	35000408ALMFT	IN
2	1041C0700X	Clinical Social Worker	34000886A	IN

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	150990000	OTHER	IN	MAGELLAN
2	000000299295	OTHER	IN	ANTHEM
3	4352922	OTHER	IN	AETNA

General Provider Information

NPI Number	:	1871537753
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. SUSAN MARIE TIELKER-SHARPE LCSW LMFT ACSW

Provider Business Mailing Address
First Line	:	4656 W JEFFERSON BLVD
Second Line	:	SUITE 285
City	:	FT WAYNE
State	:	IN
Zip	:	46804
Country	:	US
Telephone Number	:	260-422-9372
Fax Number	:	260-422-0843

Provider Business Practice Location Address
First Line	:	4656 W JEFFERSON BLVD
Second Line	:	SUITE 285
City	:	FT WAYNE
State	:	IN
Zip	:	46804
Country	:	US
Telephone Number	:	260-422-9372
Fax Number	:	260-422-0843

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/15/2006
Last Update Date	:	03/19/2013

Similar Medicare Providers

1003813692 — CARDIOSOM OF FT. WAYNE, INC
Practice Location Address:

1625 MAGNAVOX WAY
FT WAYNE, IN
46804-1535

Practice Phone: 888-857-5337
Practice Fax: 260-459-9247

1073510178 — CARDIOSOM LLC DBA MD SLEEP OF FT. WAYNE
Practice Location Address:

1625 MAGNAVOX WAY
FT WAYNE, IN
46804-1535

Practice Phone: 260-459-9248
Practice Fax: 260-459-9247

1083684948 — CARDIOVASCULAR ASSOCIATES OF NORTHEASTERN INDIANA LLC
Practice Location Address:

7900 W JEFFERSON BLVD , SUITE 303
FT WAYNE, IN
46804-4128

Practice Phone: 260-436-6098
Practice Fax: 260-436-3173

1750358347 — DALE FREDERICK FATH OD
Practice Location Address:

7750 W JEFFERSON BLVD
FT WAYNE, IN
46804

Practice Phone: 260-459-9595
Practice Fax: 260-459-9494

1578528790 — HOME CARE SERVICES, INC
Practice Location Address:

6202 CONSTITUTION DR , SUITE C
FT WAYNE, IN
46804-1583

Practice Phone: 260-459-2917
Practice Fax: 260-459-2894

1164524781 — MR. THOMAS J DOUST LCSW
Practice Location Address:

3154 MALLARD COVE LANE
FT WAYNE, IN
46804

Practice Phone: 260-432-2489
Practice Fax: 260-432-8236

Directions to “ MRS. SUSAN MARIE TIELKER-SHARPE LCSW LMFT ACSW” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.