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Contact Information

LIFE STAGES THERAPY CENTER, INC
409 E COOK RD
SUITE 100
FORT WAYNE, IN46825-3600
 Phone: 260-498-9933
 Fax:
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Clinical

103TC0700X 62 Psychologist, Clinical
 

Case Manager/Care Coordinator

171M00000X
 

Community/Behavioral Health

251S00000X
 

Counselor

101Y00000X
 

Developmental Therapist

222Q00000X
 

General Practice

208D00000X 99 Physician/Undefined Physician type[6]
 

Marriage & Family Therapist

106H00000X
 

Occupational Therapist

225X00000X 67 Occupational Therapist in Private Practice
 

Physical Therapist

225100000X 65 Physical Therapist in Private Practice
 

School

103TS0200X 62 Psychologist, Clinical
 

Social Worker

104100000X
 

Speech-Language Pathologist

235Z00000X 15 Speech Language Pathologist
Indicates primary specialty

NPI Profile & details for LIFE STAGES THERAPY CENTER, INC

NPI Number 1376974378
LBN Legal business name LIFE STAGES THERAPY CENTER, INC
Authorized official MARLA SOUDER - (PRESIDENT/COO)
Entity Organization
Organization subpart 1 No
Enumeration date 12/02/2013
Last updated 12/02/2013 - About 13 years ago
Identifiers
IN License # 20042225A
1 Some organization health care providers are made up of components that furnish different types of health care or have separate physical locations where health care is furnished. These components and physical locations are not themselves legal entities, but are part of the organization health care provider (which is a legal entity). A covered organization provider may decide that its subparts (if it has any) should have their own NPI numbers. If a subpart conducts any HIPAA standard transactions on its own (e.g., separately from its parent), it must obtain its own NPI number.

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