Alt Therapy LLC

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

Legal business name

ALT THERAPY LLC

Practice address

1313 E Harding Dr
Urbana, IL 61801-6452

Phone

(815) 242-0701

NPI assigned

Jun 9, 2023

Organization subpart

No

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

Authorized official

Name

Tyler Koontz, LSWNPI 1649699786

Title

Co-Owner

Phone

(618) 367-2138

Specialties & licenses 2

Addresses

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Tyler Koontz, LSW

  • Social Worker
  • Champaign, IL
  • NPI 1649699786
  NPD Authorized official

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

{
    "created_epoch": "1686268800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1686268800000",
    "number": "1457035677",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1313 E HARDING DR",
            "city": "URBANA",
            "state": "IL",
            "postal_code": "618016452",
            "telephone_number": "815-242-0701"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1313 E HARDING DR",
            "city": "URBANA",
            "state": "IL",
            "postal_code": "618016452",
            "telephone_number": "815-242-0701"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ALT THERAPY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-06-09",
        "last_updated": "2023-06-09",
        "certification_date": "2023-06-09",
        "status": "A",
        "authorized_official_last_name": "KOONTZ",
        "authorized_official_first_name": "TYLER",
        "authorized_official_title_or_position": "CO-OWNER",
        "authorized_official_telephone_number": "618-367-2138",
        "authorized_official_credential": "LSW"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Social Worker",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Brian David Allison, R.PH.
• Jarrod N Almaroad, MD
• Stephanie Almaroad, APRN, CRNA
• Kamel Alomari, RSA
• Shadi Alshammary
• Jessica Jo Alumbaugh
• Anant Singh Amar, MD
• Marybeth Ambrose
• Karla Rae Ambroz, MD
• Nina Amilineni, MD

• Clinical Social Worker in Urbana, IL
• Providers in Urbana, IL by specialty
• Clinical Social Worker in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 9, 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.