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INTERDISCIPLINARY COMMUNITY AUTISM NETWORK INC NPI 1336579754


NPI Information

NPI: 1336579754
Provider Name: INTERDISCIPLINARY COMMUNITY AUTISM NETWORK, INC

Doing Business As: ICAN

Classification: Community/Behavioral Health - 251S00000X
Entity Type: Organization
Address:
409 E COOK RD
SUITE 100
FORT WAYNE, IN
ZIP 46825
Phone: (260) 498-9933
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INTERDISCIPLINARY COMMUNITY AUTISM NETWORK, INC is a community behavioral health in Fort Wayne, IN. The provider is a private or public agency usually under local government jurisdiction, responsible for assuring the delivery of community based mental health, intellectual disabilities, substance abuse and/or behavioral health services to individuals with those disabilities. Services may range from companion care, respite, transportation, community integration, crisis intervention and stabilization, supported employment, day support, prevocational services, residential support, therapeutic and supportive consultation, environmental modifications, intensive in-home therapy and day treatment, in addition to traditional mental health and behavioral treatment. INTERDISCIPLINARY COMMUNITY AUTISM NETWORK, INC NPI is 1336579754. The provider is registered as an organization entity type and is a multi-specialty group.
The provider Is Doing Business As Ican.

The provider's business location address is:

409 E COOK RD
SUITE 100
FORT WAYNE, IN
ZIP 46825-600
Phone: (260) 498-9933

The provider's authorized official is Marla Jean Souder .
The authorized official title is President/coo and has the following contact phone number (260) 498-9933.

The enumeration date for this NPI number is 11/21/2013 and was last updated on 11/21/2013.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1101Y00000XCounselorNo
2103TC0700XPsychologistClinical20042225AINDIANANo
3103TS0200XPsychologistSchoolNo
41041C0700XSocial WorkerClinicalNo
5171M00000XCase Manager/Care CoordinatorNo
6222Q00000XDevelopmental TherapistNo
7225100000XPhysical TherapistNo
8235Z00000XSpeech-Language PathologistNo
9251S00000XCommunity/Behavioral HealthYes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.