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Timothy James Prentice , MA, LMHC

Counselor - Mental Health β€’ Fort Wayne, IN

Active NPI 1881203560 Individual Practitioner Male Practitioner
Practice location in NPPES

2100 Goshen Rd
Fort Wayne, IN 468081493

Call 2602718941 Location details and other listings
Medical Disclaimer

This profile restates public CMS/NPPES data; T-MedInfo gives no medical advice — consult a licensed professional, and call 911 for emergencies.

Practice Location & Contact Primary Location

Practice Address

2100 Goshen Rd

Fort Wayne, IN 468081493

Telephone 2602718941

NPI first issued

2020

The year this clinician's National Provider Identifier (NPI) was issued. An NPI is a unique 10-digit ID that US health care providers use for billing.

What this does not show: NPI first issued

NPIs have been issued only since 2005, so this year is not necessarily when the clinician started practicing.

Source: CMS NPPES NPI Registry.

Medicare assignment not listed

CMS data do not show whether this clinician accepts Medicare assignment. This does not mean they do not accept Medicare. Ask the office.

Medicare assignment applies to Original Medicare. It does not tell you whether the clinician is in a Medicare Advantage plan's network, accepts other insurance, or is taking new patients.

Source: CMS Doctors and Clinicians; Medicare.gov, β€œDoes your provider accept Medicare as full payment?”

Guide: What Medicare assignment means

No telehealth indicator

CMS shows this indicator only when recent Medicare claims include telehealth services. The clinician may still offer telehealth; ask the office.

Source: CMS, Telehealth Indicator on Medicare Care Compare (fact sheet, January 2023); CMS Doctors and Clinicians.

Guide: How Medicare covers telehealth

Compared with the same specialty in Fort Wayne and Indiana

499 active clinicians are listed under Counselor - Mental Health with a practice address in Fort Wayne, IN (5,059 in Indiana).

Addresses are self-reported to NPPES and may be out of date.

Telehealth indicator in Fort Wayne

1.8% of these 499 clinicians have the CMS telehealth indicator.

10.4% of these 499 clinicians are listed by CMS as accepting Medicare assignment.

Sources: CMS Doctors and Clinicians, CMS NPPES NPI Registry. Specialty names follow the NUCC Health Care Provider Taxonomy.

Text: T-MedInfo Β· Report an error.

Specialties & License Numbers Reported to NPPES

Self-certified to NPPES: 2026-09-02
Counselor - Mental Health Primary Specialty

NUCC Taxonomy Code: 101YM0800X

License # reported to NPPES IN 39006131A
Check License Status with the State Board License numbers are self-reported to NPPES; T-MedInfo does not confirm them against state records. Current status: Indiana Professional Licensing Agency.
Look Up on State Board Site

Clinicians Sharing This Practice Address or Phone

Clinicians sharing this NPPES address, phone or fax; a shared contact does not mean they work together.

7 listed
Alisa Briones , NP

Family Medicine

NPI 1740821925

Nurse Practitioner

Samantha Fredrickson , FNP

Nurse Practitioner - Family

NPI 1659008670

Family Nurse Practitioner

Dr. Ambreen Ghori , MD

Psychiatry & Neurology - Child & Adolescent Psychiatry

NPI 1326458514

Doctor of Medicine (M.D.)

Emilee King

Social Worker - Clinical

NPI 1346794997
Scott Mcalister , MSW, LCSW

Social Worker - Clinical

NPI 1770583718

Master of Social Work, Licensed Clinical Social Worker

Matthew Wilcox

Physician Assistant

NPI 1679185938

Career & Practice History Timeline

Changes recorded in monthly NPPES data files: addresses, names, credentials, specialties and NPI status

10 Historical Events
πŸ“
Updated Practice Location September 02, 2026

Registered at 2100 GOSHEN RD, FORT WAYNE, IN 468081493 (Tel: 2602718941)

πŸ“
Updated Business Mailing Address September 02, 2026

Registered at 2100 GOSHEN RD, FORT WAYNE, IN 468081493 (Tel: 2602718941)

πŸ‘€
Provider Name / Credentials Updated September 02, 2026

Recorded as TIMOTHY PRENTICE, MA, LMHC

πŸŽ“
Medical Taxonomy / Specialty Registered (Primary Specialty) September 02, 2026

Counselor (license number reported to NPPES: IN 39006131A)

βœ…
NPI Profile Active July 28, 2020

NPI status registered as active in NPPES database

πŸ“
Practice Location (Initial Record) July 28, 2020

Registered at 909 E STATE BLVD, FORT WAYNE, IN 468053458 (Tel: 2604812700)

πŸ“
Business Mailing Address (Initial Record) July 28, 2020

Registered at 909 E STATE BLVD, FORT WAYNE, IN 468053458 (Tel: 2604829125)

πŸ‘€
Provider Name / Credentials (Initial Record) July 28, 2020

Recorded as TIMOTHY PRENTICE, MA, LMHC-A

πŸŽ“
Medical Taxonomy / Specialty Registered (Primary Specialty) July 28, 2020

Counselor

🟒
Initial NPI Registration & Enumeration July 28, 2020

First registered as active Individual Practitioner in NPPES Database.

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NPI Administrative Meta

NPI Number: 1881203560
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: July 28, 2020
Last Update: September 02, 2026
Sole Proprietor: No

Other Counselor - Mental Health Specialists in Fort Wayne

All Counselor - Mental Health Specialists in Fort Wayne

Mailing Address

2100 Goshen Rd

Fort Wayne, IN 468081493

Phone: 2602718941

About This Data NPPES fields (address, phone, specialty, license) are self-reported and may be outdated; Medicare fields follow the CMS dataset named in each section. Correct directly at NPPES.