Organization Active NPI

Joan Louise Pontius

  • Professional Counselor
  • South Bend, IN
National Provider Identifier
1336574748
Registry record updated Sep 5, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
Legal business name
JOAN LOUISE PONTIUS
Practice address
219 N Dixie Way
Suite135
South Bend, IN 46637-3369
Phone
(574) 360-3305
Fax
(574) 271-3740
NPI assigned
Sep 5, 2013
Last updated
Sep 5, 2013By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 5, 2013

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

Authorized official

Name
Ms. Joan Louise Pontius, LMHC
Title
Therapist
Phone
(574) 360-3305

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Professional Counselor 101YP2500X IN Primary
Psychiatry Physician 2084P0800X IN

Addresses

Primary practice location

219 N Dixie Way
Suite135
South Bend, IN 46637-3369

Mailing address

219 N Dixie Way
Suite135
South Bend, IN 46637-3369
Phone (574) 360-3305

Other identifiers 1

IdentifierTypeStateIssuer
1700138492MedicaidIN

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1378339200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1378339200000",
    "number": "1336574748",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "219 N DIXIE WAY",
            "address_2": "SUITE135",
            "city": "SOUTH BEND",
            "state": "IN",
            "postal_code": "466373369",
            "telephone_number": "574-360-3305",
            "fax_number": "574-271-3740"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "219 N DIXIE WAY",
            "address_2": "SUITE135",
            "city": "SOUTH BEND",
            "state": "IN",
            "postal_code": "466373369",
            "telephone_number": "574-360-3305",
            "fax_number": "574-271-3740"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JOAN LOUISE PONTIUS",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-09-05",
        "last_updated": "2013-09-05",
        "status": "A",
        "authorized_official_last_name": "PONTIUS",
        "authorized_official_first_name": "JOAN",
        "authorized_official_middle_name": "LOUISE",
        "authorized_official_title_or_position": "THERAPIST",
        "authorized_official_telephone_number": "574-360-3305",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "LMHC"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "IN",
            "license": null,
            "primary": true
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "IN",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1700138492",
            "state": "IN"
        }
    ],
    "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 Sep 5, 2013; 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.