THE CENTER FOR COURAGEOUS LIVING LLC (NPI# 1457842460) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1457842460 |
| Entity Type | Organization |
| Organization Name | THE CENTER FOR COURAGEOUS LIVING LLC |
| Practice Address |
125 S Virginia St Crystal Lake IL 60014-5845 |
| Practice Telephone | 8478098494 |
| Mailing Telephone | 8157074806 |
| Mailing Fax Number | 8159778715 |
| Enumeration Date | 2018-05-24 |
| Last Update Date | 2020-01-28 |
| Authorized Official Name | KATIE (KATHLEEN) M KROENING (COUNSELOR/OWNDER) |
| Authorized Official Telephone | 8478098494 |
| Authorized Official Credential | LCSW |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 261QM0801X |
Clinic/Center Specialization: Mental Health (Including Community Mental Health Center) |
149.016805 | IL | Ambulatory Health Care Facilities |
| Y | 1041C0700X |
Social Worker Specialization: Clinical |
149.016805 | IL | Behavioral Health & Social Service Providers |
| Street Address |
125 S VIRGINIA ST |
| City | CRYSTAL LAKE |
| State | IL |
| Zip Code | 60014-5845 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1659743946 | Melissa Bachelder | Social Worker | 125 S Virginia St, Crystal Lake, IL 60014-5845 | 2015-10-26 |
| 1215493176 | Kelly Ann Parise | Counselor | 125 S Virginia St, Crystal Lake, IL 60014-5845 | 2019-02-15 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1497394720 | Lorelei Mariano | Physical Therapist | 350 E Congress Parkway Ste A, Crystal Lake, IL 60014 | 2020-01-03 |
| 1396227070 | Behavioral Services for Autism, Inc | Behavioral Analyst | 1095 Pingree Road, Suite 204, Crystal Lake, IL 60014 | 2018-08-30 |
| 1831635564 | Isis Mendoza-garnica | Counselor | 6803 Rose Ave, Crystal Lake, IL 60014 | 2017-01-19 |
| 1134664402 | Derick Dermatology, LLC | Non-Pharmacy Dispensing Site | 525 E Congress Parkway, Suite 200, Crystal Lake, IL 60014 | 2016-12-22 |
| 1306394051 | Highland Park Cvs, L.L.C. | Durable Medical Equipment & Medical Supplies | 177 W Virginia Street, Crystal Lake, IL 60014 | 2016-09-12 |
| 1124492830 | Align Spine & Orthopaedics | Durable Medical Equipment & Medical Supplies | 60 B West Terra Cotta Ave, #265, Crystal Lake, IL 60014 | 2015-11-18 |
| 1558747428 | Shabana Nawaz | Optometrist | 4777 Northwest Highway, Crystal Lake, IL 60014 | 2015-08-03 |
| 1548649205 | Daniel Okon | Social Worker | 304 Charllote Ave, Crystal Lake, IL 60014 | 2015-05-27 |
| 1154729838 | Crystal Lake Center for Chronic Pain Sc | Nurse Practitioner | 1 South Northwest Highway, Crystal Lake, IL 60014 | 2014-12-12 |
| 1558763581 | Brooke Nicole Grandt | Occupational Therapist | 394 Heisler Ct, Crystal Lake, IL 60014 | 2014-09-22 |
| Find all providers in zip 60014 | ||||
| Taxonomy Code | 1041C0700X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Social Worker |
| Specialization | Clinical |
| A social worker who holds a master’s or doctoral degree in social work from an accredited school of social work in addition to at least two years of post-master’s supervised experience in a clinical setting. The social worker must be licensed, certified, or registered at the clinical level in the jurisdiction of practice. A clinical social worker provides direct services, including interventions focused on interpersonal interactions, intrapsychic dynamics, and life management issues. Clinical social work services are based on bio-psychosocial perspectives. Services consist of assessment, diagnosis, treatment (including psychotherapy and counseling), client-centered advocacy, consultation, evaluation, and prevention of mental illness, emotional, or behavioral disturbances. |
| Notes: Source: National Association of Social Workers, 2008 [7/1/2009: definition modified] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1013579085 | Sara Panke | Social Worker | 1387 Parkridge Ct, Crystal Lake, IL 60014-8693 | 2019-07-01 |
| 1750832044 | Pamela Weeks | Social Worker | 5 Virginia Rd, Crystal Lake, IL 60014-7959 | 2016-10-20 |
| 1659743946 | Melissa Bachelder | Social Worker | 125 S Virginia St, Crystal Lake, IL 60014-5845 | 2015-10-26 |
| 1013393222 | Cheryl Barnhart | Social Worker | 331 Maplewood Ln, Crystal Lake, IL 60014-4267 | 2015-08-11 |
| 1649684606 | Tia Poggensee | Social Worker | 6703 Huntley Rd, Crystal Lake, IL 60014-5363 | 2014-06-18 |
| 1306259270 | Michele Rogers | Social Worker | 68 Carmella Dr, Crystal Lake, IL 60012-3517 | 2014-06-08 |
| 1649609348 | Torrie Benson-pryor | Social Worker | 610 N Route 31, Suite E, Crystal Lake, IL 60012-3715 | 2013-11-04 |
| 1235571290 | Elizabeth M Krotser | Social Worker | 7115 Virginia Rd Ste 108, Crystal Lake, IL 60014-3110 | 2013-07-18 |
| 1225304694 | Jill Pixley | Social Worker | 390 Congress Parkway, Suite J, Crystal Lake, IL 60014 | 2012-03-29 |
| 1407156904 | Kristin Elise Weeks | Social Worker | 918 Glasgow Ln, Crystal Lake, IL 60014-1904 | 2010-10-30 |
| Find all providers in CRYSTAL LAKE | ||||
| City | CRYSTAL LAKE |
| Zip Code | 60014 |
Please comment or provide details below to improve the information on THE CENTER FOR COURAGEOUS LIVING LLC.
| 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.