Organization Active NPI

Launchpad Foundation, Inc.

  • Clinical Social Worker
  • Fort Wayne, IN
National Provider Identifier
1245974344
Registry record updated Apr 25, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
Legal business name
LAUNCHPAD FOUNDATION, INC.
Practice address
2200 Lake Ave Ste 260
Fort Wayne, IN 46805-5351
Phone
(260) 424-0411
Fax
(260) 424-3530
NPI assigned
Apr 25, 2022
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 25, 2022

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

Authorized official

Name
John W Blanks III
Title
Administrative Director
Phone
(260) 424-0411

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social WorkerGroup: 193200000X MULTI-SPECIALTY GROUP 1041C0700X Primary

Addresses

Primary practice location

2200 Lake Ave Ste 260
Fort Wayne, IN 46805-5351

Mailing address

2200 Lake Ave Ste 260
Fort Wayne, IN 46805-5351
Phone (260) 424-0411

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1650844800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1650844800000",
    "number": "1245974344",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2200 LAKE AVE STE 260",
            "city": "FORT WAYNE",
            "state": "IN",
            "postal_code": "468055351",
            "telephone_number": "260-424-0411",
            "fax_number": "260-424-3530"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2200 LAKE AVE STE 260",
            "city": "FORT WAYNE",
            "state": "IN",
            "postal_code": "468055351",
            "telephone_number": "260-424-0411",
            "fax_number": "260-424-3530"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LAUNCHPAD FOUNDATION, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-04-25",
        "last_updated": "2022-04-25",
        "certification_date": "2022-04-25",
        "status": "A",
        "authorized_official_last_name": "BLANKS",
        "authorized_official_first_name": "JOHN",
        "authorized_official_middle_name": "W",
        "authorized_official_title_or_position": "ADMINISTRATIVE DIRECTOR",
        "authorized_official_telephone_number": "260-424-0411",
        "authorized_official_name_suffix": "III"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Wayne, IN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 25, 2022; 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.