PLENA MIND CENTER, LLC (NPI# 1790287969) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1790287969 |
Entity Type | Organization |
Organization Name | PLENA MIND CENTER, LLC |
Practice Address |
1450 Techny Rd Northbrook IL 60062 |
Mailing Address |
1450 Techny Rd Northbrook IL 60062-5447 |
Practice Telephone | 8475625612 |
Practice Fax Number | 8475625613 |
Mailing Telephone | 8475625612 |
Mailing Fax Number | 8475625613 |
Enumeration Date | 2018-03-05 |
Last Update Date | 2020-04-27 |
Authorized Official Name | SHANNON GOEBEL-PAUL (EXECUTIVE DIRECTOR) |
Authorized Official Telephone | 8475625612 |
Is Organization Subpart | N |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
N | 261Q00000X | Clinic/Center | Ambulatory Health Care Facilities | ||
Y | 261QM0855X |
Clinic/Center Specialization: Adolescent and Children Mental Health |
Ambulatory Health Care Facilities |
Street Address |
1450 TECHNY RD |
City | NORTHBROOK |
State | IL |
Zip Code | 60062 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1669635108 | Firuza Aliyeva | Psychiatry & Neurology | 1450 Techny Rd, Northbrook, IL 60062-5447 | 2008-07-03 |
1851999783 | Plena Medical Group LLC | Psychiatry & Neurology | 1450 Techny Rd, Northbrook, IL 60062-5447 | 2020-10-13 |
1003343872 | Child and Family Psychiatric Center LLC | Clinical Neuropsychologist | 1450 Techny Rd, Northbrook, IL 60062-5447 | 2017-05-11 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1508487067 | Cvs Aoc Services, L.L.C. | Optometrist | 936 Willow Road, Store 0141, Northbrook, IL 60062 | 2020-05-06 |
1386103885 | Jennifer Venegas | Behavior Technician | 5 Revere Dr Suit 120, Northbrook, IL 60062 | 2019-03-14 |
1720558281 | Taylor Hundley | Behavior Technician | 5 Revere Dr. Suite 120, Northbrook, IL 60062 | 2018-11-27 |
1609344027 | Melissa Cepeda | Behavior Technician | 5 Revere Dr Suite 120, Northbrook, IL 60062 | 2018-11-03 |
1235606658 | Candace Cheyenne Kaiser | Behavior Technician | 5 Revere Dr, Suite 120, Northbrook, IL 60062 | 2018-10-24 |
1275058745 | The Renfrew Center of Illinois | Counselor | 5 Revere Dr, Suite 100, Northbrook, IL 60062 | 2017-08-07 |
1467984773 | Ayzenshteyn Chiropractic | Chiropractor | 3210 Doolittle Dr., Northbrook, IL 60062 | 2017-03-28 |
1396282695 | Josephine Driscoll | Physician Assistant | 400 Skokie Blvd., Suite 450, Northbrook, IL 60062 | 2017-01-24 |
1396297842 | Lauren Raphael Lcsw LLC | Social Worker | 3050 Pheasant Creek Drive, Apt. 104, Northbrook, IL 60062 | 2016-11-01 |
1851847073 | Jassim Vailoces | Physical Therapist | 634 Academy Dr, Northbrook, IL 60062 | 2016-08-28 |
Find all providers in zip 60062 |
Taxonomy Code | 261QM0855X |
Grouping | Ambulatory Health Care Facilities |
Classification | Clinic/Center |
Specialization | Adolescent and Children Mental Health |
An entity, facility, or distinct part of a facility providing diagnostic, treatment, and prescriptive services related to mental and behavioral disorders in children and adolescents. Services may be provided to parents and family members of the patient in the form of conjoint, group, or individual therapy, and education and/or training. |
Notes: [7/1/2003: new] |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1073157707 | Healthy Minds International Inc | Clinic/Center | 3400 Dundee Rd Ste 150, Northbrook, IL 60062-2333 | 2019-11-06 |
1669941720 | Laura G Gerber, PC | Clinic/Center | 85 Revere Dr Ste B, Northbrook, IL 60062-8001 | 2018-11-19 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1891393781 | Camelot Care Centers, LLC | Clinic/Center | 34121 North Route 45 Suite 207, Grayslake, IL 60030 | 2020-10-13 |
1831797141 | Camelot Care Centers, LLC | Clinic/Center | 5301 E State St Ste 208, Rockford, IL 61108-2397 | 2020-10-09 |
1255954780 | The Transformation Specialists LLC | Clinic/Center | 813 Ash St, Flossmoor, IL 60422-2213 | 2020-05-19 |
1689296162 | Kmetko & Associates, Ltd. | Clinic/Center | 4043 N Ravenswood Ave Ste 121, Chicago, IL 60613-1176 | 2020-05-07 |
1962035709 | Ellen M Griffin Psyd PC | Clinic/Center | 155 N Michigan Ave Ste 512, Chicago, IL 60601-7612 | 2020-02-20 |
1962034488 | Global Executive Council Services | Clinic/Center | 5766 N Lincoln Ave Ste 4s, Chicago, IL 60659-4734 | 2020-02-12 |
1366082232 | Westcare Illinois, Inc | Clinic/Center | 1100 W Cermak Rd Ste B116, Chicago, IL 60608-4540 | 2020-01-08 |
1295379972 | Compass Health Center Oakbrook Pllc | Clinic/Center | 700 Oakmont Ln, Westmont, IL 60559-5551 | 2019-11-05 |
1427690676 | Midwest Family and Community Resources PC | Clinic/Center | 3330 W 177th St Fl 1, Hazel Crest, IL 60429-2184 | 2019-10-09 |
1720629041 | Monte Nido Illinois, LLC | Clinic/Center | 27w121 80th St, Naperville, IL 60565-1270 | 2019-10-08 |
Find all providers with the same taxonomy |
City | NORTHBROOK |
Zip Code | 60062 |
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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.