Neurotechtonics Inc NFP

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

Legal business name

NEUROTECHTONICS INC NFP

Doing business as

NEUROTECHTONICS INC NFP

Practice address

4350 211TH St Ste 210a
Matteson, IL 60443-3082

Phone

(708) 833-7939

NPI assigned

Mar 17, 2023

Organization subpart

No

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

Authorized official

Name

Mr. Brian Aubrey Johnson, LCPC, LPHA

Title

Clinical Supervisor

Phone

(708) 200-0034

Specialties & licenses 3

Addresses

Other names 1

• NEUROTECHTONICS INC NFP Doing business as

Locations

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

{
    "created_epoch": "1679011200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1707955200000",
    "number": "1245932086",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1213 BLACKHAWK DR STE 210A",
            "city": "UNIVERSITY PARK",
            "state": "IL",
            "postal_code": "604843321",
            "telephone_number": "708-200-0034",
            "fax_number": "708-833-7939"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4350 211TH ST STE 210A",
            "city": "MATTESON",
            "state": "IL",
            "postal_code": "604433082",
            "telephone_number": "708-833-7939"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1213 Blackhawk Dr",
            "address_purpose": "LOCATION",
            "city": "University Park",
            "state": "IL",
            "postal_code": "604843321",
            "country_code": "US",
            "telephone_number": "708-200-0034",
            "fax_number": "708-833-7939",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "NEUROTECHTONICS INC NFP",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-03-17",
        "last_updated": "2024-02-15",
        "certification_date": "2024-02-15",
        "status": "A",
        "authorized_official_last_name": "JOHNSON",
        "authorized_official_first_name": "BRIAN",
        "authorized_official_middle_name": "AUBREY",
        "authorized_official_title_or_position": "CLINICAL SUPERVISOR",
        "authorized_official_telephone_number": "708-200-0034",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "LCPC, LPHA"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Professional",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "NEUROTECHTONICS INC NFP",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Professional Counselor in Matteson, IL
• Providers in Matteson, IL by specialty
• Professional Counselor in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 15, 2024; 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.