Calla Clinic, LLC

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

34004717A Issued in IN

Legal business name

CALLA CLINIC, LLC

Practice address

164 Sagamore Pkwy W
West Lafayette, IN 47906-1569

Phone

(765) 427-5758

Fax

(866) 871-7013

NPI assigned

Aug 15, 2014

Organization subpart

No

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

Authorized official

Name

Lisa Bradley Werth, LCSW

Title

Owner / Clinical Director

Phone

(765) 427-5758

Specialties & licenses 2

Addresses

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

{
    "created_epoch": "1408060800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1408060800000",
    "number": "1881093706",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "164 SAGAMORE PKWY W",
            "city": "WEST LAFAYETTE",
            "state": "IN",
            "postal_code": "479061569",
            "telephone_number": "765-427-5758",
            "fax_number": "866-871-7013"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "164 SAGAMORE PKWY W",
            "city": "WEST LAFAYETTE",
            "state": "IN",
            "postal_code": "479061569",
            "telephone_number": "765-427-5758",
            "fax_number": "866-871-7013"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CALLA CLINIC, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-08-15",
        "last_updated": "2014-08-15",
        "status": "A",
        "authorized_official_last_name": "WERTH",
        "authorized_official_first_name": "LISA",
        "authorized_official_middle_name": "BRADLEY",
        "authorized_official_title_or_position": "OWNER / CLINICAL DIRECTOR",
        "authorized_official_telephone_number": "765-427-5758",
        "authorized_official_credential": "LCSW"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "IN",
            "license": "87000637A",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Social Worker, Clinical",
            "state": "IN",
            "license": "34004717A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jody Lynn Butterfield
• Katie Byers, MOT OTR
• Marcilena Cabello
• Jeffrey S. Cahoon, MD
• Yun Cai
• Calla Wellness Center, LLC
• Taja Calvin
• Deanna Campbell, RD
• Kaydence Campos
• Janet Canino, PH.D., LMFT

• 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 Aug 15, 2014; 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.