William Owen Funston, LSW

Primary specialty

Social WorkerTaxonomy code 104100000X

License

33012047A Issued in IN

Practice address

4727 Miami St
South Bend, IN 46614-3225

Phone

(574) 231-8480

NPI assigned

Aug 2, 2023

Last updated

Aug 9, 2024By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1690934400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1723161600000",
    "number": "1730861501",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1441 E 84TH PL",
            "city": "MERRILLVILLE",
            "state": "IN",
            "postal_code": "464106578",
            "telephone_number": "219-769-4005",
            "fax_number": "219-794-2010"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4727 MIAMI ST",
            "city": "SOUTH BEND",
            "state": "IN",
            "postal_code": "466143225",
            "telephone_number": "574-231-8480"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1441 E 84th Pl",
            "address_purpose": "LOCATION",
            "city": "Merrillville",
            "state": "IN",
            "postal_code": "464106578",
            "country_code": "US",
            "telephone_number": "219-769-4005",
            "fax_number": "219-794-2010",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "FUNSTON",
        "first_name": "WILLIAM",
        "middle_name": "OWEN",
        "credential": "LSW",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2023-08-02",
        "last_updated": "2024-08-09",
        "certification_date": "2024-08-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "IN",
            "license": "33012047A",
            "primary": true
        },
        {
            "code": "172V00000X",
            "taxonomy_group": "",
            "desc": "Community Health Worker",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Social Worker in South Bend, IN
• Providers in South Bend, IN by specialty
• Social Worker in Indiana

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