BREAKING FREE (NPI# 1700923927) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1700923927 |
| Entity Type | Organization |
| Organization Name | BREAKING FREE |
| Practice Address |
800 W 5th Ave Suite 102 B Naperville IL 60563-8965 |
| Practice Telephone | 6303552585 |
| Practice Fax Number | 6303552676 |
| Mailing Telephone | 6303552585 |
| Mailing Fax Number | 6303552676 |
| Enumeration Date | 2007-01-30 |
| Last Update Date | 2020-08-22 |
| Authorized Official Name | MS. KIM CACCIATO (BILLING SPECIALIST) |
| Authorized Official Telephone | 6305728228 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 251S00000X | Community/Behavioral Health | A-0380-0004-A | IL | Agencies |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| IL | BLUE CROSS PROVIDER NUMBE | 1839 | 01 |
| IL | DASA PROVIDER NUMBER | 0380 | 01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1295872513 | Breaking Free | Community/Behavioral Health | 120 Gale St, Suite 200, Aurora, IL 60506-5084 | 2007-01-30 |
| 1245508324 | Breaking Free | Community/Behavioral Health | 15150 Strooptown Rd, Timberville, VA 22853-2319 | 2011-12-05 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| Oregon Corporations, Companies and Business Names | BREAKING FREE | 200 South Longview Way #83, Oregon City, OR 97045 |
| Virginia Business Entities | Breaking Free | 15150 Strooptown Road, Timberville, Virginia 22853 |
| Colorado Business Entities | Breaking Free Counseling LLC | 1710 Jet Stream Dr Ste 110, Colorado Springs, CO 80921 |
| Washington State Corporations | BREAKING FREE COUNSELING PLLC | 22 Windward Dr, Bellingham, WA 98229 |
| Oregon Corporations, Companies and Business Names | BREAKING FREE LLC | 165 S Main St, Lebanon, OR 97355 |
| Connecticut Business Registrations | Breaking Free LLC | 206 Goffe Terrace, New Haven, CT 06511 |
| Oregon Corporations, Companies and Business Names | BREAKING FREE MEDIA LLC | 78672 Dowens Rd, Cottage Grove, OR 97424 |
| System for Award Management (SAM) Entities | BREAKING FREE MINISTRY, INC. | 1213 Angus Trail, Lexington, KY 40509-4115 |
| Oregon Corporations, Companies and Business Names | BREAKING FREE MVMT LLC | 1071 Fairfield Ave Apt 77, Eugene, OR 97402 |
| Colorado Business Entities | Breaking Free Productions LLC | 10251 W 44th Ave, Building #8 Unit, Wheat Ridge, CO 80033 |
| Street Address |
800 W 5TH AVE SUITE 102 B |
| City | NAPERVILLE |
| State | IL |
| Zip Code | 60563-8965 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1275170185 | Aspb Therapy Pathways | Counselor | 800 W 5th Ave, Ste 104, Naperville, IL 60563-8965 | 2019-12-10 |
| 1356865075 | Cynthia Leslie Rupp | Contractor | 800 W 5th Ave, Naperville, IL 60563-8965 | 2017-08-03 |
| 1184158818 | Kiersten Amport | Social Worker | 800 W 5th Ave, Suite # 205i, Naperville, IL 60563-8965 | 2017-04-19 |
| 1841724341 | Joy Anderson | Contractor | 800 W 5th Ave, Ste 102 A, Naperville, IL 60563-8965 | 2017-04-12 |
| 1053853036 | Premiercare Consulting, LLC | Case Management | 800 W 5th Ave, Naperville, IL 60563-8965 | 2016-11-08 |
| 1831640424 | Advance Sports Therapy | Mechanotherapist | 800 W 5th Ave, Suite 100g, Naperville, IL 60563-8965 | 2016-10-18 |
| 1952850778 | Azlaan Arif | Mechanotherapist | 800 W 5th Ave, Suite 100g, Naperville, IL 60563-8965 | 2016-09-22 |
| 1336522622 | Samantha Ross | Contractor | 800 W 5th Ave, Ste. 102 A, Naperville, IL 60563-8965 | 2015-07-04 |
| 1457754574 | Jose Antonio Castro IIi | Contractor | 800 W 5th Ave, Suite 102a, Naperville, IL 60563-8965 | 2014-10-02 |
| 1174937007 | Alison Tews | Contractor | 800 W 5th Ave, Ste. 102 A, Naperville, IL 60563-8965 | 2014-06-18 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1952902884 | Julia Ann Gottschalk | Nurse Practitioner | 1979 Mcdowell Rd, Unit 103, Naperville, IL 60563 | 2020-11-06 |
| 1700484847 | Lee Michael Harms I | Social Worker | 1952 Mcdowell Road, Suite 305, Naperville, IL 60563 | 2020-10-12 |
| 1881208478 | Poornima Swamy Gangaji | Dentist | 760 N, Illinois Rte 59, Ste100, Naperville, IL 60563 | 2020-09-01 |
| 1851901219 | Adiana Lebron | Social Worker | 2948 Artestian Road, Naperville, IL 60563 | 2020-07-31 |
| 1194342014 | Ingrid Lara | Behavioral Analyst | 1975 Mcdowell Rd #101, Naperville, IL 60563 | 2020-06-26 |
| 1396383030 | Jack Kelly | Assistant Behavior Analyst | 1975 Mcdowell Rd. #101, Naperville, IL 60563 | 2019-12-12 |
| 1316583529 | Arvind Ramakrishnan | Behavioral Analyst | 1975 Mcdowell Rd., Naperville, IL 60563 | 2019-11-22 |
| 1679115778 | Melissa Macias | Behavioral Analyst | 1975 Mcdowell Road, #101, Naperville, IL 60563 | 2019-10-10 |
| 1629619275 | Meghann Reid Vizintos | Physician Assistant | 1763 Freedom Dr Ste 117, Naperville, IL 60563 | 2019-10-04 |
| 1417413543 | Vikram Singh Cheema | Physician Assistant | 1335 North Mill Street, Naperville, IL 60563 | 2019-02-13 |
| Find all providers in zip 60563 | ||||
| Taxonomy Code | 251S00000X |
| Grouping | Agencies |
| Classification | Community/Behavioral Health |
| A private or public agency usually under local government jurisdiction, responsible for assuring the delivery of community based mental health, mental retardation, substance abuse and/or behavioral health services to individuals with those disabilities. Services may range from companion care, respite, transportation, community integration, crisis intervention and stabilization, supported employment, day support, prevocational services, residential support, therapeutic and supportive consultation, environmental modifications, intensive in-home therapy and day treatment, in addition to traditional mental health and behavioral treatment. |
| Notes: Source: National Medicaid EDI HIPAA NPI Sub Work Group [1/1/2007: modified definition] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1720541915 | Healing Mind Counseling Services LLC | Community/Behavioral Health | 1169 Banyon Ct, Naperville, IL 60540-6344 | 2019-04-13 |
| 1982143368 | Illinois Medical and Behavioral Care, LLC | Community/Behavioral Health | 1601 N Bond Street, Suite 201, Naperville, IL 60563-0115 | 2017-02-17 |
| 1538532908 | Konick and Associates, PC | Community/Behavioral Health | 3380 Lacrosse Ln, Suite 106, Naperville, IL 60564-8520 | 2015-11-07 |
| 1003201492 | Evolve Therapy and Associates, Inc. | Community/Behavioral Health | 11259 Anvil Ct, Naperville, IL 60564-8036 | 2015-04-01 |
| 1295168300 | Jawahar Alvi | Community/Behavioral Health | 5s681 Park Meadow Dr, Naperville, IL 60540-3854 | 2013-08-12 |
| 1396020640 | 360 Youth Services | Community/Behavioral Health | 1323 Bond St Ste 119, Naperville, IL 60563-2368 | 2011-10-19 |
| 1043487549 | Michele Mauro, Psy.d., P.C. | Community/Behavioral Health | 3309 Cool Springs Ct, Naperville, IL 60564-8240 | 2008-05-13 |
| 1720256225 | Charlene Thobe Scott, Inc. Dba Riverwalk Counseling Center, Inc | Community/Behavioral Health | 710 E Ogden Ave Ste 320, Naperville, IL 60563-8620 | 2008-02-19 |
| 1275726424 | Psycholegal & Clinical Assessment Services, Inc | Community/Behavioral Health | 2135 City Gate Ln, Suite 300, Naperville, IL 60563-3081 | 2007-08-21 |
| 1720698202 | Unifying Therapy | Community/Behavioral Health | 50 S Main St Ste 200, Naperville, IL 60540-5485 | 2020-08-09 |
| Find all providers in NAPERVILLE | ||||
| City | NAPERVILLE |
| Zip Code | 60563 |
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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.