MANDALA COUNSELING SERVICES LLC (NPI# 1376199356) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1376199356 |
| Entity Type | Organization |
| Organization Name | MANDALA COUNSELING SERVICES LLC |
| Practice Address |
8600 Northwest Hwy # 14 Crystal Lake IL 60012-2706 |
| Mailing Address |
339 Ridge Rd Barrington IL 60010-2331 |
| Practice Telephone | 2245451225 |
| Mailing Telephone | 2245451225 |
| Enumeration Date | 2019-08-14 |
| Last Update Date | 2019-08-14 |
| Authorized Official Name | MR. DAVID AUSTEN GIBBONS (COUNSELOR) |
| Authorized Official Telephone | 2245451225 |
| Authorized Official Credential | MA |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QM0801X |
Clinic/Center Specialization: Mental Health (Including Community Mental Health Center) |
Ambulatory Health Care Facilities |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1871134627 | Mandala Counseling Services LLC | Counselor | 6361 Presidential Ct Ste 101, Fort Myers, FL 33919-3583 | 2019-10-02 |
| Street Address |
8600 NORTHWEST HWY # 14 |
| City | CRYSTAL LAKE |
| State | IL |
| Zip Code | 60012-2706 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1033574629 | Joan M Ryan | Counselor | 610 N Route 31, Suite E, Crystal Lake, IL 60012 | 2015-12-23 |
| 1285972331 | Lauren Elyse Westerman | Physical Therapist | 1000 Brighton Ln, Crystal Lake, IL 60012 | 2013-01-24 |
| 1447537469 | Sean Gale | Pharmacist | 135 Carmella Dr, Crystal Lake, IL 60012 | 2011-11-04 |
| 1477836625 | Judy Meekyung Fakhouri | Pharmacist | 315 N. Route 31, Crystal Lake, IL 60012 | 2011-09-23 |
| 1730462136 | Leslie Dawn Weckerlin | Pharmacist | 315 N Route 31, Crystal Lake, IL 60012 | 2011-09-21 |
| 1639452188 | Laura Jean Galles | Pharmacist | 315 N. Routet 31, Crystal Lake, IL 60012 | 2011-09-21 |
| 1326320516 | Stacey Jean Knuth | Pharmacist | 315 North Route 31, Crystal Lake, IL 60012 | 2011-09-13 |
| 1356469803 | Donn Orien Humphries | Chiropractor | 690 N Route 31, Suite F, Crystal Lake, IL 60012 | 2007-03-26 |
| 1538204508 | Midwest Physical Therapy Ctr | Clinic/Center | 630 N Rt 31, Suite 103, Crystal Lake, IL 60012 | 2007-02-20 |
| 1356488415 | Charlotte Joy Parcels | Social Worker | 8600 Route 14, Suite 110, Crystal Lake, IL 60012 | 2007-01-30 |
| Find all providers in zip 60012 | ||||
| Taxonomy Code | 261QM0801X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Mental Health (Including Community Mental Health Center) |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1285231555 | Association for Individual Development | Clinic/Center | 236 W Crystal Lake Ave, Crystal Lake, IL 60014-5847 | 2020-10-08 |
| 1184260770 | Clearbrook Mchenry Cmhc | Clinic/Center | 6500 Northwest Hwy Unit 16e, Crystal Lake, IL 60014-3117 | 2019-11-19 |
| 1235789827 | Clearbrook Cmhc | Clinic/Center | 2 Crystal Lake Plz Ste C, Crystal Lake, IL 60014-3118 | 2019-09-16 |
| 1376671461 | Mchenry County Mental Health Board | Clinic/Center | 620 Dakota St, Crystal Lake, IL 60012-3732 | 2007-03-01 |
| 1457842460 | The Center for Courageous Living LLC | Clinic/Center | 125 S Virginia St, Crystal Lake, IL 60014-5845 | 2018-05-24 |
| 1134575558 | Rosecrance Inc | Clinic/Center | 620 Dakota St, Crystal Lake, IL 60012 | 2016-05-05 |
| 1447610381 | Mathers Clinic, LLC | Clinic/Center | 145 S Virginia St, Crystal Lake, IL 60014-7226 | 2016-03-04 |
| 1154579068 | Mchenry County Mental Health Board | Clinic/Center | 620 Dakota St, Crystal Lake, IL 60012-3732 | 2008-09-04 |
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|---|---|---|---|---|
| 1225639990 | Mindy Forman, Psyd, LLC | Clinic/Center | 1020 Milwaukee Ave Ste 110, Deerfield, IL 60015-3555 | 2020-11-07 |
| 1346840295 | Stopka Professional Counseling LLC | Clinic/Center | 13125 Steeplechase Dr, New Lenox, IL 60451-1320 | 2020-10-29 |
| 1346848785 | Wellness Hearted Therapy LLC | Clinic/Center | 2675 S Cedar Glen Dr, Arlington Heights, IL 60005-5303 | 2020-10-16 |
| 1457959256 | Association for Individual Development | Clinic/Center | 708 N Bridge St, Yorkville, IL 60560-1105 | 2020-10-14 |
| 1386241123 | Envision Unlimited | Clinic/Center | 1801 N Spaulding Ave, Chicago, IL 60647-4926 | 2020-10-05 |
| 1881291789 | Jessica Weisbach, LLC | Clinic/Center | 2257 N Kedzie Blvd Apt 3, Chicago, IL 60647-2561 | 2020-10-04 |
| 1619574803 | Envision Unlimited | Clinic/Center | 2124 W 82nd Pl, Chicago, IL 60620-5358 | 2020-10-01 |
| 1144827320 | Envision Unlimited | Clinic/Center | 4919 N Clark St, Chicago, IL 60640-3514 | 2020-10-01 |
| 1194322370 | Envision Unlimited | Clinic/Center | 4911 S Hoyne Ave, Chicago, IL 60609-4721 | 2020-10-01 |
| 1841807369 | Trinity Services Inc. | Clinic/Center | 14315 108th Ave Ste 222, Orland Park, IL 60467-5701 | 2020-09-29 |
| Find all providers with the same taxonomy | ||||
| City | CRYSTAL LAKE |
| Zip Code | 60012 |
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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.