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

Jacob M Fawley

Individual provider Mental Health Counselor · NPI 1528727807

Jacob M Fawley is a Mental Health Counselor in Fort Wayne, Indiana. Licensed in Indiana. Registered with an NPI since 2021.

Licensed in
IN
In the registry since
2021

Practice location Address checks out

4150 Illinois Rd
Fort Wayne, IN 46804-1208
Phone: (260) 702-3752
Fax: (260) 702-3752
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Mental Health Counselor (primary) Taxonomy 101YM0800X · Licence 39002631A (IN)

Record details

NPI number1528727807
Entity typeIndividual (Type 1)
GenderMale
Sole proprietorNo
NPI enumeratedDecember 14, 2021
Last updated in NPPESDecember 14, 2021
Certification dateDecember 14, 2021

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