Individual provider Active NPI

Joann Lynn Phillips, M.S.W., L.S.W.

  • Social Worker
  • South Bend, IN
National Provider Identifier
1720143886
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Social WorkerTaxonomy code 104100000X
License
33004973A Issued in IN
Practice address
108 N Main St
Suite #305, Intrigue Counseling
South Bend, IN 46601-1625
Phone
(574) 234-3515
NPI assigned
Dec 27, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Social Worker 104100000X 33004973A IN Primary

Addresses

Primary practice location

108 N Main St
Suite #305, Intrigue Counseling
South Bend, IN 46601-1625

Mailing address

1714 Georgian Dr
South Bend, IN 46614-6236
Phone (574) 231-8847

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
33004973AINMDSocial Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Intrigue Counseling, Inc Past Accepting new patients

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1167177600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1720143886",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1714 GEORGIAN DR",
            "city": "SOUTH BEND",
            "state": "IN",
            "postal_code": "466146236",
            "telephone_number": "574-231-8847"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "108 N MAIN ST",
            "address_2": "SUITE #305, INTRIGUE COUNSELING",
            "city": "SOUTH BEND",
            "state": "IN",
            "postal_code": "466011625",
            "telephone_number": "574-234-3515"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PHILLIPS",
        "first_name": "JOANN",
        "middle_name": "LYNN",
        "name_prefix": "Ms.",
        "credential": "M.S.W., L.S.W.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-12-27",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "IN",
            "license": "33004973A",
            "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 Jul 8, 2007; 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.