Individual provider Active NPI

Linda Ponterio, NCSP

  • School Psychologist
  • South Bend, IN
National Provider Identifier
1477374221
Registry record updated Oct 23, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
School PsychologistTaxonomy code 103TS0200X
License
10213353 Issued in IN
Practice address
1360 E Monroe St
South Bend, IN 46615-1004
Phone
(574) 387-9422
NPI assigned
Oct 23, 2024
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 23, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
School Psychologist 103TS0200X 10213353 IN Primary

Addresses

Primary practice location

1360 E Monroe St
South Bend, IN 46615-1004

Mailing address

1360 E Monroe St
South Bend, IN 46615-1004

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
10213353INMDSchool Psychologist

NPI Registry JSON

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

{
    "created_epoch": "1729641600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1729641600000",
    "number": "1477374221",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1360 E MONROE ST",
            "city": "SOUTH BEND",
            "state": "IN",
            "postal_code": "466151004"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1360 E MONROE ST",
            "city": "SOUTH BEND",
            "state": "IN",
            "postal_code": "466151004",
            "telephone_number": "574-387-9422"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PONTERIO",
        "first_name": "LINDA",
        "credential": "NCSP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-10-23",
        "last_updated": "2024-10-23",
        "certification_date": "2024-10-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TS0200X",
            "taxonomy_group": "",
            "desc": "Psychologist, School",
            "state": "IN",
            "license": "10213353",
            "primary": true
        }
    ],
    "identifiers": [],
    "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 Oct 23, 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.