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

Nicole Conrad, 106S00000X

Individual provider Mental Health Counselor · NPI 1922654722

Nicole Conrad, 106S00000X is a Mental Health Counselor in Fort Wayne, Indiana. Practices as a sole proprietor. Licensed in Indiana.

Licensed in
IN
In the registry since
2019
Specialties on file
2

Practice location Address checks out

908 Manck Dr
Fort Wayne, IN 46814-8995
Phone: (260) 271-5285
Show map & directions

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

Specialties & licences

Mental Health Counselor (primary) Taxonomy 101YM0800X (IN)
Behavior Technician Taxonomy 106S00000X · Licence 25-482997 (IN)

Record details

NPI number1922654722
Entity typeIndividual (Type 1)
GenderFemale
Credentials 106S00000X
Sole proprietorYes
NPI enumeratedAugust 16, 2019
Last updated in NPPESNovember 12, 2025
Certification dateNovember 12, 2025

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