Sally a Timmons LLC

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

34004910A Issued in IN

Legal business name

SALLY A TIMMONS LLC

Practice address

120 Sagamore Parkway West
West Lafayette, IN 47906

Phone

(765) 404-6431

Fax

(765) 477-7843

NPI assigned

Aug 8, 2007

Organization subpart

Yes

Parent organization

SALLY A TIMMONS LLCAs reported in NPPES

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

Authorized official

Name

Sally Ann Timmons, LCSW RNNPI 1114952397

Title

Registered Agent

Phone

(765) 404-6431

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in IN

Enrollment records 1

Part of

Sally a Timmons LLC

Locations

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Sally Ann Timmons, LCSW, RN

  • Clinical Social Worker
  • West Lafayette, IN
  • NPI 1114952397
  Medicare reassignment NPD Authorized official
• Malissa Kaye Crowe, LCSW

  • Clinical Social Worker
  • West Lafayette, IN
  • NPI 1114965563
  NPD (past)

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

{
    "created_epoch": "1186531200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1195084800000",
    "number": "1871784330",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1805 SKYLINE RD",
            "city": "LAFAYETTE",
            "state": "IN",
            "postal_code": "47905",
            "telephone_number": "765-404-6431",
            "fax_number": "765-477-7843"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "120 SAGAMORE PARKWAY WEST",
            "city": "WEST LAFAYETTE",
            "state": "IN",
            "postal_code": "47906",
            "telephone_number": "765-404-6431",
            "fax_number": "765-477-7843"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SALLY A TIMMONS LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "SALLY A TIMMONS LLC",
        "enumeration_date": "2007-08-08",
        "last_updated": "2007-11-15",
        "status": "A",
        "authorized_official_last_name": "TIMMONS",
        "authorized_official_first_name": "SALLY",
        "authorized_official_middle_name": "ANN",
        "authorized_official_title_or_position": "REGISTERED AGENT",
        "authorized_official_telephone_number": "765-404-6431",
        "authorized_official_credential": "LCSW RN"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Social Worker, Clinical",
            "state": "IN",
            "license": "34004910A",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM BCBS",
            "identifier": "000000375779",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Devona Salazar
• Wendy Salazar
• Rachel Salem, SLP
• Ryan Joseph Salerno
• Yves Phillipe Sallade, BCBA
• Maritza Salmeron
• Sanctuary Home Care Agency LLC
• Sanctuary Personal Service Agency
• Jacob Sanders
• Sarah Elizabeth Sautter, DDS

• Clinical Social Worker in West Lafayette, IN
• Providers in West Lafayette, IN by specialty
• Clinical Social Worker in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 15, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.