Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Jay Bastian LLC

Organization Clinical Social Worker · NPI 1740780204

Jay Bastian LLC is a Clinical Social Worker in Fort Wayne, Indiana. Works from 2 locations. Licensed in Indiana.

Licensed in
IN
In the registry since
2018
What do these letters mean?
LLC — Limited liability company
A form of business registration, not a clinical qualification.

See every abbreviation used in this directory →

Practice location Address checks out

9329 Illinois Rd
Fort Wayne, IN 46804-5796
Phone: (260) 418-9653
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (1)

  • 5420 Sherington Rd, Fort Wayne, IN 46814-7510 — (260) 418-9653

Specialties & licences

Clinical Social Worker (primary) Taxonomy 1041C0700X · Licence 34007970A (IN)

Record details

NPI number1740780204
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Jay Bastian — Psychotherapist · (260) 418-9653
NPI enumeratedFebruary 20, 2018
Last updated in NPPESOctober 26, 2024
Certification dateOctober 26, 2024
Mailing address9329 Illinois Rd, Fort Wayne, IN 46804-5796

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