Wieland, Kevin L.
Wieland, Kevin L. is an sole proprietor health care provider with primary practice located at 1415 Magnavox Way Suite 120, Fort Wayne IN 46804-1565. He recently has only one registered license in Behavioral Health & Social Service Providers / Clinical, which is considered as his primary health care specialty. Wieland, Kevin L. can be contacted via phone (260) 483-7207.Contact Information
Primary practice address
1415 Magnavox Way Suite 120
Fort Wayne IN 46804-1565
Phone: (260) 483-7207
Fax: (260) 483-0836
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Behavioral Health & Social Service Providers / Clinical | 103TC0700X | 20041419A | Indiana |
Profile Details
| NPI number | 1497737902 |
|---|---|
| LBN Legal business name | Wieland, Kevin L. |
| Credentials | PSY.D., HSPP |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Nov 18th, 2005 |
| Last updated | Dec 19th, 2025 - about last year |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1497737902 | NPPES |
| Indiana | MEDICAID | 200360310A |
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