| Oaktree Guidance & Wellness Center | |
|
9910 Dupont Circle Drive Suite 140 Fort Wayne IN 46825 | |
| (260) 570-4515 | |
| (260) 209-0762 |
| Full Name | Oaktree Guidance & Wellness Center |
|---|---|
| Speciality | Psychologist |
| Location | 9910 Dupont Circle Drive, Fort Wayne, Indiana |
| Authorized Official Name and Position | Jenny Seiss (CLINICAL PSYCHOLOGIST) |
| Authorized Official Contact | 2607506461 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Oaktree Guidance & Wellness Center 119 W. Tenth St Auburn IN 46706-2230 Ph: (260) 570-4515 | Oaktree Guidance & Wellness Center 9910 Dupont Circle Drive Suite 140 Fort Wayne IN 46825 Ph: (260) 570-4515 |
| NPI Number | 1003276643 |
|---|---|
| Provider Enumeration Date | 02/24/2016 |
| Last Update Date | 02/24/2016 |
| Medicare PECOS PAC ID | 2769789692 |
|---|---|
| Medicare Enrollment ID | O20160321001432 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1003276643 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103T00000X | Psychologist | 20042462A (Indiana) | Primary |
| Provider Name | Jenny E Seiss |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1861635831 PECOS PAC ID: 1254598410 Enrollment ID: I20120131000803 |
| Provider Name | Diana Lightfoot |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1568838613 PECOS PAC ID: 0648556993 Enrollment ID: I20170420002672 |
| Provider Name | Bree Ricker |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1508175274 PECOS PAC ID: 2961835988 Enrollment ID: I20191205001699 |
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