Fogerty Music Therapy, LLC

Primary specialty

Music TherapistTaxonomy code 225A00000X

Legal business name

FOGERTY MUSIC THERAPY, LLC

Practice address

515 S Woodscrest Dr Ste B
Bloomington, IN 47401-5303

Phone

(812) 340-9269

NPI assigned

Nov 1, 2011

Organization subpart

No

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

Authorized official

Name

Jonnetta Fogerty, MM, MT-BC

Title

Owner, Director

Phone

(812) 340-9269

Specialties & licenses 1

Addresses

Other names 1

• Fogerty Music Therapy Doing business as

Locations

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

{
    "created_epoch": "1320105600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1458086400000",
    "number": "1700162971",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4729 SHALIMAR DR",
            "city": "COLUMBIA",
            "state": "SC",
            "postal_code": "292061048",
            "telephone_number": "812-340-9269"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "515 S WOODSCREST DR STE B",
            "city": "BLOOMINGTON",
            "state": "IN",
            "postal_code": "474015303",
            "telephone_number": "812-340-9269"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FOGERTY MUSIC THERAPY, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-11-01",
        "last_updated": "2016-03-16",
        "status": "A",
        "authorized_official_last_name": "FOGERTY",
        "authorized_official_first_name": "JONNETTA",
        "authorized_official_title_or_position": "OWNER, DIRECTOR",
        "authorized_official_telephone_number": "812-340-9269",
        "authorized_official_credential": "MM, MT-BC"
    },
    "taxonomies": [
        {
            "code": "225A00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Music Therapist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Fogerty Music Therapy",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Mark Stafford Floyd, M.D.
• Nathan Floyd, LCSW
• Ashton Flynn, RBT
• Jessica Lynnae Flynn
• Sean Flynn, MD
• Daniel Fogerty, SLP
• Jonnetta J Fogerty, MM, MT-BC
• Sheyla Fogle
• Fonthill Behavioral Health
• Foot Specialist LLC

• Music Therapist in Bloomington, IN
• Providers in Bloomington, IN by specialty
• Music Therapist in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 16, 2016; 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.