Teknon Foundation, LLC

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

Legal business name

TEKNON FOUNDATION, LLC

Practice address

222 US Highway 41 Ste 207
Schererville, IN 46375-1275

Phone

(219) 808-0793

Fax

(765) 374-0628

NPI assigned

Jun 17, 2015

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Mrs. Natylee J Glover

Title

Administrator

Phone

(219) 808-0793

Specialties & licenses 1

Addresses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1434499200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1471219200000",
    "number": "1205217155",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "222 US HIGHWAY 41 STE 207",
            "city": "SCHERERVILLE",
            "state": "IN",
            "postal_code": "463751275",
            "telephone_number": "219-808-0793",
            "fax_number": "765-374-0628"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "222 US HIGHWAY 41 STE 207",
            "city": "SCHERERVILLE",
            "state": "IN",
            "postal_code": "463751275",
            "telephone_number": "219-808-0793",
            "fax_number": "765-374-0628"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TEKNON FOUNDATION, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-06-17",
        "last_updated": "2016-08-15",
        "status": "A",
        "authorized_official_last_name": "GLOVER",
        "authorized_official_first_name": "NATYLEE",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "219-808-0793",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 15, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.