Individual provider Active NPI

Timothy Franklin Koons, LCSW

  • Clinical Social Worker
  • Danville, IL
National Provider Identifier
1609176171
Registry record updated Jun 5, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
149015227 Issued in IL
Practice address
210 Avenue C
Danville, IL 61832-5410
Phone
(217) 442-3200
Fax
(217) 442-7460
NPI assigned
Oct 29, 2010
Last updated
Jun 5, 2012By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 5, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 149015227 IL Primary

Addresses

Primary practice location

210 Avenue C
Danville, IL 61832-5410

Mailing address

210 Avenue C
Danville, IL 61832-5410
Phone (217) 442-3200

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
149015227ILMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1288310400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1338854400000",
    "number": "1609176171",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "210 AVENUE C",
            "city": "DANVILLE",
            "state": "IL",
            "postal_code": "618325410",
            "telephone_number": "217-442-3200",
            "fax_number": "217-442-7460"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "210 AVENUE C",
            "city": "DANVILLE",
            "state": "IL",
            "postal_code": "618325410",
            "telephone_number": "217-442-3200",
            "fax_number": "217-442-7460"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KOONS",
        "first_name": "TIMOTHY",
        "middle_name": "FRANKLIN",
        "name_prefix": "Mr.",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2010-10-29",
        "last_updated": "2012-06-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "IL",
            "license": "149015227",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Danville, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 5, 2012; 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.