Dyann Inc

Primary specialty

Mental Health Clinic/Center (Including Community Mental Health Center)Taxonomy code 261QM0801X

Legal business name

DYANN INC

Practice address

3624 W 216TH Street
Matteson, IL 60443-2713

Phone

(708) 481-4080

Fax

(708) 481-7725

NPI assigned

Oct 31, 2006

Organization subpart

No

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

Authorized official

Name

Mrs. Dyann K Bockstahler, MSW LCSW

Title

Licensed Clinical Social Worker Pre

Phone

(708) 481-4098

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1162252800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1811073034",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3624 W 216TH STREET",
            "city": "MATTESON",
            "state": "IL",
            "postal_code": "604432713",
            "telephone_number": "708-481-4080",
            "fax_number": "708-481-7725"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3624 W 216TH STREET",
            "city": "MATTESON",
            "state": "IL",
            "postal_code": "604432713",
            "telephone_number": "708-481-4080",
            "fax_number": "708-481-7725"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DYANN INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-31",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "BOCKSTAHLER",
        "authorized_official_first_name": "DYANN",
        "authorized_official_middle_name": "K",
        "authorized_official_title_or_position": "LICENSED CLINICAL SOCIAL WORKER PRE",
        "authorized_official_telephone_number": "708-481-4098",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "MSW LCSW"
    },
    "taxonomies": [
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Mental Health Clinic/Center (Including Community Mental Health Center) in Matteson, IL
• Providers in Matteson, IL by specialty
• Mental Health Clinic/Center (Including Community Mental Health Center) in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.