Laynie Foundation

Primary specialty

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

Legal business name

LAYNIE FOUNDATION

Practice address

4747 Lincoln Mall Dr
Suite 604
Matteson, IL 60443-3811

Phone

(708) 617-8548

Fax

(708) 617-8017

NPI assigned

Apr 2, 2013

Organization subpart

No

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

Authorized official

Name

Dr. Summer A Matheson, PHD

Title

C.O.O.

Phone

(708) 617-8548

Specialties & licenses 1

Addresses

Other identifiers 1

Tax ID family

Laynie Foundation3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

Organizations that report the same tax identification number in the National Provider Directory.

• Laynie Foundation

  • Community/Behavioral Health Agency
  • Matteson, IL
  • NPI 1790076628
  NPD tax ID
• Laynie Foundation, Incorporated

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Chicago, IL
  • NPI 1558890889
  NPD tax ID

Locations

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

{
    "created_epoch": "1364860800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1364860800000",
    "number": "1932442571",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4747 LINCOLN MALL DR",
            "address_2": "SUITE 604",
            "city": "MATTESON",
            "state": "IL",
            "postal_code": "604433811",
            "telephone_number": "708-617-8548",
            "fax_number": "708-617-8017"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4747 LINCOLN MALL DR",
            "address_2": "SUITE 604",
            "city": "MATTESON",
            "state": "IL",
            "postal_code": "604433811",
            "telephone_number": "708-617-8548",
            "fax_number": "708-617-8017"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LAYNIE FOUNDATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-04-02",
        "last_updated": "2013-04-02",
        "status": "A",
        "authorized_official_last_name": "MATHESON",
        "authorized_official_first_name": "SUMMER",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "C.O.O.",
        "authorized_official_telephone_number": "708-617-8548",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PHD"
    },
    "taxonomies": [
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1790076628",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Adrienne Lambert
• Peyton Lammons
• Brittany Lampkin
• Leanne Latocha
• Laynie Foundation
• Lemon & Vo OD's LTD.
• Eric Lietz
• Life Guardian Angels Healthcare LLC
• Life Guardian Angels Homecare LLC
• Synthia Diane Lindbloom, RPH

• 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 Apr 2, 2013; 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.