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Paytons Place, LLC

NPI 1104247337ActiveOrganization· Psychologist, Clinical· Fort Wayne, IN

Psychologist, Clinical in Fort Wayne, Indiana, registered in NPPES in December 2013. The authorized official on file is Marla Souder, PSY.D., HSPP, Owner/President/Psychologist.

Overview

NPI1104247337
StatusActive
Entity typeOrganization
NPI issuedDec 13, 2013
Last updated in NPPESDec 13, 2013

Specialties and licenses

TaxonomyCodeLicenseState
Psychologist, Clinical Primary103TC0700X20042225AIN
Case Manager/Care Coordinator171M00000X——
Family Medicine207Q00000X——
Developmental Therapist222Q00000X——
Physical Therapist225100000X——
Occupational Therapist225X00000X——
Speech-Language Pathologist235Z00000X——
Student in an Organized Health Care Education/Training Program390200000X——

About license numbers in NPPES

Exclusion screening

ListResultDetails
HHS-OIG LEIE · Nov 10, 2026No matchChecked by NPI and by name + state
North Carolina Medicaid · Nov 11, 2026No match—
New York OMIG · Nov 11, 2026No match—
Ohio Medicaid · Nov 11, 2026No match—
Pennsylvania Medicheck · Nov 11, 2026No match—
Washington HCA · Nov 11, 2026No match—

Official OIG search · How matching works ·Bulk check a roster

Medicare

Enrollment (PECOS)Not in the public enrollment file of Oct 1, 2026

Medicare sources and data years

Other clinical psychologists in Fort Wayne

All 68 clinical psychologists in Fort Wayne · All clinical psychologists in Indiana