INA S. CARLSON PH.D., HSPP
NPI 1265490650
Psychologist - Clinical in Fort Wayne, IN

Active since May 03, 2006PECOS Enrolled
100/100
CMS Quality Rating
1909 CAREW ST, FORT WAYNE, IN 46805(260) 481-2800(260) 969-8442 Get Directions Write a Review

NPPES record last updated: October 17, 2022. Verified against the NPPES registry weekly; last sync: July 19, 2026.

Record update history: Oct 17, 2022, Jun 4, 2021 (2 updates tracked since 2021).

About Ina S. Carlson Ph.d., Hspp NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

INA S. CARLSON PH.D., HSPP (NPI 1265490650) is an individual clinical provider in Fort Wayne, Indiana, licensed in Indiana (20090244A) and active in the NPI registry since May 2006. She is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1265490650
Entity TypeIndividualFemale
Primary Taxonomy103TC0700X
Provider Legal NameINA S. CARLSONCredential: PH.D., HSPP
Location Address1909 CAREW STFort Wayne, IN 46805-4707
Mailing Address11109 Parkview Plaza Dr # 117Fort Wayne, IN 46845-1701
Fax(260) 969-8442
Sole ProprietorNo
Enumeration DateMay 3, 2006
Last NPPES UpdateOctober 17, 20222 updates tracked since enumeration
NPPES CertifiedOctober 15, 2022
NPI 1265490650 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

Primary SpecialtyPsychologist · ClinicalBehavioral Health & Social Service Providers
Taxonomy Code103TC0700X
License Licensed in IN · 20090244A
Definition

A psychologist who provides continuing and comprehensive mental and behavioral health care for individuals and families; consultation to agencies and communities; training, education and supervision; and research-based practice. It is a specialty in breadth -- one that is broadly inclusive of severe psychopathology -- and marked by comprehensiveness and integration of knowledge and skill from a broad array of disciplines within and outside of psychology proper. The scope of clinical psychology encompasses all ages, multiple diversities and varied systems.

1909 CAREW ST, Fort Wayne, IN 46805

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

Enrolled in Medicare (PECOS)

Ina S. Carlson Ph.d., Hspp is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Eligible to Order & Refer Part B Labs & Imaging Durable Medical Equipment Home Health Agency Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 46805 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient
$161.76 typical visit price
range $53.07 – $161.76
Typical copayment $40.44 (range $13.26 – $40.44)
Most-billed visit code 99205
Established Patient
$94.22 typical visit price
range $16.93 – $132.22
Typical copayment $23.55 (range $4.23 – $33.05)
Most-billed visit code 99214
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Medicare Quality Performance CMS QPP · MIPS

Performance in the CMS Quality Payment Program: the MIPS final score across four weighted categories, and the individual quality measures reported to Medicare.

100/100
MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program
Scored as part of a group practice
Quality93.07
Promoting Interoperability100
Improvement Activities40
Cost91.08

Other Providers at the Same Location NPPES 11

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

Counselor (Mental Health)
1909 CAREW ST
FORT WAYNE, IN 46805
Counselor (Mental Health)
1909 CAREW ST
FORT WAYNE, IN 46805
Counselor (Mental Health)
1909 CAREW ST
FORT WAYNE, IN 46805
Counselor (Mental Health)
1909 CAREW ST
FORT WAYNE, IN 46805
Counselor (Mental Health)
1909 CAREW ST
FORT WAYNE, IN 46805
Social Worker (Clinical)
1909 CAREW ST
FORT WAYNE, IN 46805
Nurse Practitioner
1909 CAREW ST
FORT WAYNE, IN 46805
Psychiatry & Neurology (Psychiatry)
1909 CAREW ST
FORT WAYNE, IN 46805

Frequently Asked Questions

The NPI number assigned to this healthcare provider is 1265490650, enumerated as an "individual" on May 03, 2006.

The provider is located at 1909 CAREW ST FORT WAYNE, IN 46805 and the phone number is (260) 481-2800.

Psychologist with taxonomy code 103TC0700X and a focus in Clinical.