SALLY A TIMMONS LLC (NPI# 1871784330) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1871784330 |
| Entity Type | Organization |
| Organization Name | SALLY A TIMMONS LLC |
| Practice Address |
120 Sagamore Parkway West West Lafayette IN 47906 |
| Mailing Address |
1805 Skyline Rd Lafayette IN 47905 |
| Practice Telephone | 7654046431 |
| Practice Fax Number | 7654777843 |
| Mailing Telephone | 7654046431 |
| Mailing Fax Number | 7654777843 |
| Enumeration Date | 2007-08-08 |
| Last Update Date | 2007-11-15 |
| Authorized Official Name | SALLY ANN TIMMONS (REGISTERED AGENT) |
| Authorized Official Telephone | 7654046431 |
| Authorized Official Credential | LCSW RN |
| Is Organization Subpart | Y |
| Parent Organization Name | SALLY A TIMMONS LLC |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1041C0700X |
Social Worker Specialization: Clinical |
34004910A | IN | Behavioral Health & Social Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| IN | ANTHEM BCBS | 000000375779 | 01 |
| Street Address |
120 SAGAMORE PARKWAY WEST |
| City | WEST LAFAYETTE |
| State | IN |
| Zip Code | 47906 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1457990848 | Wickshire West Lafayette Opco LLC | Assisted Living Facility | 3575 Senior Place, West Lafayette, IN 47906 | 2020-01-02 |
| 1992290530 | Cameron Eldred | Specialist/Technologist | 3367 Edison Dr, West Lafayette, IN 47906 | 2018-06-26 |
| 1720593403 | Devin Kay Hall | Specialist/Technologist | 900 John R. Wooden Drive, West Lafayette, IN 47906 | 2017-12-04 |
| 1609398270 | Christian Floirendo | Specialist/Technologist | 2225 Willowbrook Dr, #207, West Lafayette, IN 47906 | 2017-07-14 |
| 1699176800 | Leslie Michell Pell | Registered Nurse | 1873 Kingeider Drive, West Lafayette, IN 47906 | 2014-09-07 |
| 1881007581 | Usv Optical Inc. | Eyewear Supplier (Equipment, not the service) | 2636 Us52 Sagamore Pkwy, West Lafayette, IN 47906 | 2014-06-10 |
| 1588089536 | Sarah Pierce | Pharmacist | 2636 Us 52, West Lafayette, IN 47906 | 2014-02-27 |
| 1811228240 | Angelica D. Kokkalis | Acupuncturist | 124 Westwood Dr., W. Lafayette, IN 47906 | 2010-01-25 |
| 1255529335 | Greater Lafayette Health Services | Clinic/Center | 3482 Mcclure Ave, West Lafayette, IN 47906 | 2007-10-15 |
| 1770793150 | Volker Karl Thomas | Marriage & Family Therapist | 2512 Covington Street, West Lafayette, IN 47906 | 2007-05-23 |
| Find all providers in zip 47906 | ||||
| Taxonomy Code | 1041C0700X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Social Worker |
| Specialization | Clinical |
| A social worker who holds a master’s or doctoral degree in social work from an accredited school of social work in addition to at least two years of post-master’s supervised experience in a clinical setting. The social worker must be licensed, certified, or registered at the clinical level in the jurisdiction of practice. A clinical social worker provides direct services, including interventions focused on interpersonal interactions, intrapsychic dynamics, and life management issues. Clinical social work services are based on bio-psychosocial perspectives. Services consist of assessment, diagnosis, treatment (including psychotherapy and counseling), client-centered advocacy, consultation, evaluation, and prevention of mental illness, emotional, or behavioral disturbances. |
| Notes: Source: National Association of Social Workers, 2008 [7/1/2009: definition modified] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1306310677 | Ryaan J Mansouri | Social Worker | 61 Point W, West Lafayette, IN 47906-5075 | 2019-01-18 |
| 1356869135 | Cydney Woolley | Social Worker | 703 3rd St Bldg Room1120, West Lafayette, IN 47907-2081 | 2017-08-31 |
| 1164638326 | Gwenda Sue Eiler | Social Worker | 1601 Stadium Mall Dr., Purdue Univeristy Student Health Center, West Lafayette, IN 47907-2052 | 2007-05-15 |
| 1255457172 | Elisabeth J Hudson | Social Worker | 2900 N River Rd Ste O, West Lafayette, IN 47906-3744 | 2007-03-22 |
| 1760517064 | Lisa B Werth | Social Worker | 164 Sagamore Pkwy W, West Lafayette, IN 47906-1569 | 2007-02-23 |
| 1396885307 | Lou Ann Hamilton | Social Worker | 475 Stadium Mall Drive, Schleman Hall of Student Services, Room 207, West Lafayette, IN 47907-2050 | 2007-02-07 |
| 1114965563 | Malissa Kaye Crowe | Social Worker | 120 Sagamore Pkwy W, West Lafayette, IN 47906-1569 | 2006-06-04 |
| 1467932491 | Stafka Lili'uokalani Poweleit | Social Worker | 2900 N River Rd Ste C, West Lafayette, IN 47906-3744 | 2018-08-20 |
| 1487055422 | Luis Javier Balcazar Jr. | Social Worker | 601 Stadium Mall Dr, West Lafayette, IN 47907-2052 | 2014-09-09 |
| 1982031530 | Megan Burton | Social Worker | 601 Stadium Mall Dr, West Lafayette, IN 47907-2052 | 2013-09-27 |
| Find all providers in WEST LAFAYETTE | ||||
| City | WEST LAFAYETTE |
| Zip Code | 47906 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.