# MIDWEST ADDICTION PSYCHIATRIC & PSYCHOLOGICAL SERVICES LLC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** MAPPS
- **Organization subpart:** No

## Provider details

- **NPI number:** 1336190149
- **Authorized official:** DR. DON A MARSHALL JR. M.D. (OWNER)
- **Authorized official phone:** (260) 456-7261

## Contact information

- **Practice address:** 3010 E. STATE BLVD, STE 100, FORT WAYNE, IN 46805
- **Practice address phone:** (260) 471-0632
- **Practice address fax:** (260) 471-3451
- **Mailing address:** 3010 E STATE BLVD, SUTIE A, FORT WAYNE, IN 46805-4700
- **Mailing address phone:** (260) 471-0632
- **Mailing address fax:** (260) 471-3451

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 101YA0400X | Addiction (Substance Use Disorder) Counselor | 14060ASO | IN | Yes |
| 101YM0800X | Mental Health Counselor | 14060ASO | IN | — |
| 103T00000X | Psychologist | 14060ASO | IN | — |
| 103TA0400X | Addiction (Substance Use Disorder) Psychologist | 14060ASO | IN | — |
| 103TB0200X | Cognitive & Behavioral Psychologist | 14060ASO | IN | — |
| 103TC2200X | Clinical Child & Adolescent Psychologist | 14060ASO | IN | — |
| 103TF0200X | Forensic Psychologist | 14060ASO | IN | — |
| 1041C0700X | Clinical Social Worker | 14060ASO | IN | — |
| 106H00000X | Marriage & Family Therapist | 14060ASO | IN | — |
| 2084P0800X | Psychiatry Physician | 14060ASO | IN | — |
| 2084P0802X | Addiction Psychiatry Physician | 14060ASO | IN | — |

## Other

- **Enumeration date:** 05/15/2006
- **Last updated:** 03/02/2018