SELF CONNECTED THERAPY LLC (NPI# 1013521301) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1013521301 |
| Entity Type | Organization |
| Organization Name | SELF CONNECTED THERAPY LLC |
| Practice Address |
2189 N. Rt. 83 #292 Round Lake Beach IL 60073 |
| Practice Telephone | 8479427849 |
| Mailing Telephone | 8479427849 |
| Enumeration Date | 2020-09-03 |
| Last Update Date | 2020-09-03 |
| Authorized Official Name | ASHLEY GROB (THERAPIST) |
| Authorized Official Telephone | 8479427849 |
| Authorized Official Credential | LCSW |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QM0850X |
Clinic/Center Specialization: Adult Mental Health |
Ambulatory Health Care Facilities |
| Street Address |
2189 N. RT. 83 #292 |
| City | ROUND LAKE BEACH |
| State | IL |
| Zip Code | 60073 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1609477280 | Marlene A Espinosa | Pharmacist | 2680 N, Il 83, Round Lake Beach, IL 60073 | 2020-11-02 |
| 1225637614 | Sharice Ellenwood | Counselor | 1087 N Village Dr, Round Lake Beach, IL 60073 | 2020-10-18 |
| 1538710900 | Mykola Rudyk | Dentist | 425 N Wilson Rd, Round Lake, IL 60073 | 2019-09-26 |
| 1205344173 | Shamari Mentoring Company | Counselor | 1020 W Rollins Rd, Rould Lake Heights, IL 60073 | 2018-01-13 |
| 1770007007 | Mary Burnett | Physical Therapy Assistant | 512 S Jade Lane, Round Lake, IL 60073 | 2017-07-28 |
| 1881055549 | Irina Akimova | Community Health Worker | 715 W. Judd Street, Woodstock, IL 60073 | 2016-03-09 |
| 1487051751 | Lawrence Scire | Specialist | 800 High School Drive, Round Lake, IL 60073 | 2014-12-02 |
| 1659778090 | Giacchino James Lech II | Specialist/Technologist | 609 S Jade Ln, Round Lake, IL 60073 | 2014-12-01 |
| 1407265283 | Linda Lee Eaton | Massage Therapist | 650 S Curran Road, Round Lake, IL 60073 | 2014-08-06 |
| 1609134378 | Nw Dentiq Center P.c | Dentist | 425 N.wilson Road, Round Lake, IL 60073 | 2012-05-01 |
| Find all providers in zip 60073 | ||||
| Taxonomy Code | 261QM0850X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Adult Mental Health |
| An entity, facility, or distinct part of a facility providing diagnostic, treatment, and prescriptive services related to mental and behavioral disorders in adults. |
| Notes: [7/1/2003: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
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| 1184223133 | Kevin P. Mcdunn, Psyd, LLC | Clinic/Center | 605 W Madison St Apt 2001, Chicago, IL 60661-2469 | 2020-10-21 |
| 1699372250 | Ctf Illinois | Clinic/Center | 1400 Reynolds Dr, Charleston, IL 61920-2411 | 2020-10-07 |
| 1124634852 | Prosper Counseling Services | Clinic/Center | 808 W Junior Ter Apt 303, Chicago, IL 60613-1657 | 2020-09-17 |
| 1962017665 | Hopeology, Pllc | Clinic/Center | 700 E North St Ste B, Elburn, IL 60119-7009 | 2020-09-10 |
| 1508479288 | Bash Psychotherapy Corporation | Clinic/Center | 413 E Berry Rd, Barrington, IL 60010-3317 | 2020-08-24 |
| 1326658402 | Ventura Counseling, LLC | Clinic/Center | 620 Manchester Ave, Westchester, IL 60154-2714 | 2020-08-04 |
| 1265040760 | Orchid Counseling Chicago | Clinic/Center | 451 W Melrose St Apt 610, Chicago, IL 60657-3826 | 2020-07-21 |
| 1164040630 | Sunshine Therapy Pllc | Clinic/Center | 3328 N Bell Ave, Chicago, IL 60618-6204 | 2020-07-10 |
| 1437776879 | Vesna Healing, LLC | Clinic/Center | 1225 W Morse Ave Apt 203, Chicago, IL 60626-5675 | 2020-07-01 |
| Find all providers with the same taxonomy | ||||
| City | ROUND LAKE BEACH |
| Zip Code | 60073 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.