Innovative Therapy Services, LLC

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

CW016017 Issued in PA

Legal business name

INNOVATIVE THERAPY SERVICES, LLC

Practice address

3939 W Ridge Rd
Suite B-45
Erie, PA 16506-1879

Phone

(814) 240-1011

Fax

(814) 240-1048

NPI assigned

Jun 19, 2013

Last updated

Feb 16, 2015By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Shana Lynn Bennett, LCSW

Title

Partner

Phone

(814) 240-1011

Specialties & licenses 2

Addresses

Locations

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

{
    "created_epoch": "1371600000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1424044800000",
    "number": "1982043394",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3939 W RIDGE RD",
            "address_2": "SUITE B-45",
            "city": "ERIE",
            "state": "PA",
            "postal_code": "165061879",
            "telephone_number": "814-240-1011",
            "fax_number": "814-240-1048"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3939 W RIDGE RD",
            "address_2": "SUITE B-45",
            "city": "ERIE",
            "state": "PA",
            "postal_code": "165061879",
            "telephone_number": "814-240-1011",
            "fax_number": "814-240-1048"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "INNOVATIVE THERAPY SERVICES, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-06-19",
        "last_updated": "2015-02-16",
        "status": "A",
        "authorized_official_last_name": "BENNETT",
        "authorized_official_first_name": "SHANA",
        "authorized_official_middle_name": "LYNN",
        "authorized_official_title_or_position": "PARTNER",
        "authorized_official_telephone_number": "814-240-1011",
        "authorized_official_credential": "LCSW"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "PA",
            "license": "PC005212",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "PA",
            "license": "CW016017",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Clinical Social Worker in Erie, PA
• Providers in Erie, PA by specialty
• Clinical Social Worker in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 16, 2015; 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.