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

Mr. Gregory M. Banicki, MSED

Individual provider Mental Health Counselor · NPI 1184785693

Mr. Gregory M. Banicki, MSED is a Marriage and Family Therapist in Fort Wayne, Indiana. Graduated from Indiana Medical College, School of Medicine of Purdue University in 2006, 20 years ago. Practices with Phoenix Associates Inc, a 2-clinician group and accepts Medicare assignment.

Years since qualifying
20
Trained at
Indiana Medical College, School of Medicine of Purdue University
In the registry since
2006
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Practice location Address checks out

1910 Saint Joe Center Rd
Fort Wayne, IN 46825-5000
Phone: (260) 484-5599
Fax: (260) 484-5664
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Mental Health Counselor (primary) Taxonomy 101YM0800X

Record details

NPI number1184785693
Entity typeIndividual (Type 1)
GenderMale
Credentials MSED
Sole proprietorYes
NPI enumeratedDecember 12, 2006
Last updated in NPPESJuly 8, 2007

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyMARRIAGE AND FAMILY THERAPIST
Medical schoolINDIANA MEDICAL COLLEGE, SCHOOL OF MEDICINE OF PURDUE UNIVERSITY
Graduated 2006 (20 years in practice)
Group practice Phoenix Associates Inc — 2 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

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