Active NPI
Courtney L Lane, MSW
- Social Worker
- South Bend, IN
National Provider Identifier
1063542629
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Social Worker
- Practice address
- 300 N Michigan St
Suite 420
South Bend, IN 46601-1295 - Phone
- (574) 291-9300
- Fax
- (574) 291-9301
- NPI assigned
- Mar 6, 2007
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Social Worker | 104100000X | Primary |
Addresses
Primary practice location
300 N Michigan St
Suite 420
South Bend, IN 46601-1295
Mailing address
57757 Pear Rd.
South Bend, IN 46619
Phone (574) 876-8697
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1173139200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1336089600000",
"number": "1063542629",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "57757 PEAR RD.",
"city": "SOUTH BEND",
"state": "IN",
"postal_code": "46619",
"telephone_number": "574-876-8697"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "300 N MICHIGAN ST",
"address_2": "SUITE 420",
"city": "SOUTH BEND",
"state": "IN",
"postal_code": "466011295",
"telephone_number": "574-291-9300",
"fax_number": "574-291-9301"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LANE",
"first_name": "COURTNEY",
"middle_name": "L",
"credential": "MSW",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-03-06",
"last_updated": "2012-05-04",
"status": "A"
},
"taxonomies": [
{
"code": "104100000X",
"taxonomy_group": "",
"desc": "Social Worker",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in South Bend, IN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 4, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.