Modern Connections Therapy, LLC

Primary specialty

Adult Mental Health Clinic/CenterTaxonomy code 261QM0850X

License

149019589 Issued in IL

Legal business name

MODERN CONNECTIONS THERAPY, LLC

Practice address

222 S Frances St
South Bend, IN 46617-3004

Phone

(708) 405-9181

NPI assigned

May 11, 2018

Last updated

Jul 6, 2023By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Shawn Marie Flynn, LCSW

Title

Licensed Clinical Social Worker

Phone

(708) 405-9181

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1525996800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1688601600000",
    "number": "1205326691",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "222 S FRANCES ST",
            "city": "SOUTH BEND",
            "state": "IN",
            "postal_code": "466173004",
            "telephone_number": "708-405-9181"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "222 S FRANCES ST",
            "city": "SOUTH BEND",
            "state": "IN",
            "postal_code": "466173004",
            "telephone_number": "708-405-9181"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "155 N Michigan Ave",
            "address_purpose": "LOCATION",
            "city": "Chicago",
            "state": "IL",
            "postal_code": "606017511",
            "country_code": "US",
            "telephone_number": "708-405-9181",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "MODERN CONNECTIONS THERAPY, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-05-11",
        "last_updated": "2023-07-06",
        "certification_date": "2023-07-06",
        "status": "A",
        "authorized_official_last_name": "FLYNN",
        "authorized_official_first_name": "SHAWN",
        "authorized_official_middle_name": "MARIE",
        "authorized_official_title_or_position": "LICENSED CLINICAL SOCIAL WORKER",
        "authorized_official_telephone_number": "708-405-9181",
        "authorized_official_credential": "LCSW"
    },
    "taxonomies": [
        {
            "code": "261QM0850X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adult Mental Health",
            "state": "IL",
            "license": "149019589",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Raman L. Mitra, M.D.
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• Mayank Kumar Mittal, MD
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• Keon Mobley
• Brent W Mohr, MD
• Kimberly A Mohr, MSW
• Donald Charles Mohs Jr., MD
• Aaron Michael Mojica, CRNA
• Allison Kate Molencupp, CNM

• Adult Mental Health Clinic/Center in South Bend, IN
• Providers in South Bend, IN by specialty
• Adult Mental Health Clinic/Center in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 6, 2023; 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.