NPIMap

Organization Active NPI

Woodstock Therapist LLC

  • Professional Counselor
  • Woodstock, IL
National Provider Identifier
1003358037
Registry record updated Feb 23, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
Legal business name
WOODSTOCK THERAPIST LLC
Practice address
224 W Judd St
Woodstock, IL 60098-3199
Phone
(815) 345-3400
Fax
(844) 734-1259
NPI assigned
Nov 8, 2016
Last updated
Feb 23, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 23, 2024

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Mrs. Lindsay Keisman, LCPCNPI 1912298134
Title
Owner/Therapist
Phone
(815) 345-3400

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Professional CounselorGroup: 193200000X MULTI-SPECIALTY GROUP 101YP2500X Primary
Adult Mental Health Clinic/Center 261QM0850X
Adolescent and Children Mental Health Clinic/Center 261QM0855X

Addresses

Primary practice location

224 W Judd St
Woodstock, IL 60098-3199

Mailing address

224 W Judd St
Woodstock, IL 60098-3199
Phone (815) 236-3272

Other practice location 1

1301 Pyott Rd
Lake IN The Hills, IL 60156-9794
Phone (815) 345-3400

Other practice location 2

665 Tollgate Rd Ste B
Elgin, IL 60123-9353
Phone (815) 345-3400

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20170602001149 IL Part B Supplier - Clinic/Group Practice 6507133105 Receives reassigned benefits from 5 practitioners
Practice locations: Woodstock, IL; Lake in the Hills, IL; Elgin, IL

National Provider Directory

National Provider Directory
Tax ID family
Woodstock Therapist LLC3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

Organizations that report the same tax identification number in the National Provider Directory.

Locations

665 Tollgate Rd
Ste B
Elgin, IL 60123
Phone (815) 345-3400

1301 Pyott Rd
Lake in the Hills, IL 60156
Phone (815) 345-3400

134 Cass St
Ste 3
Woodstock, IL 60098
Phone (815) 345-3400

224 W Judd St
Ste 7
Woodstock, IL 60098
Phone (815) 345-3400

224 W Judd St
Woodstock, IL 60098
Phone (815) 345-3400

Practitioners & affiliated clinicians

Practitioners 11

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1478563200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1708646400000",
    "number": "1003358037",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "224 W JUDD ST",
            "city": "WOODSTOCK",
            "state": "IL",
            "postal_code": "600983199",
            "telephone_number": "815-236-3272",
            "fax_number": "844-734-1259"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "224 W JUDD ST",
            "city": "WOODSTOCK",
            "state": "IL",
            "postal_code": "600983199",
            "telephone_number": "815-345-3400",
            "fax_number": "844-734-1259"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1301 Pyott Rd",
            "address_purpose": "LOCATION",
            "city": "Lake IN The Hills",
            "state": "IL",
            "postal_code": "601569794",
            "country_code": "US",
            "telephone_number": "815-345-3400",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "665 Tollgate Rd Ste B",
            "address_purpose": "LOCATION",
            "city": "Elgin",
            "state": "IL",
            "postal_code": "601239353",
            "country_code": "US",
            "telephone_number": "815-345-3400",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "WOODSTOCK THERAPIST LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-11-08",
        "last_updated": "2024-02-23",
        "certification_date": "2024-02-23",
        "status": "A",
        "authorized_official_last_name": "KEISMAN",
        "authorized_official_first_name": "LINDSAY",
        "authorized_official_title_or_position": "OWNER/THERAPIST",
        "authorized_official_telephone_number": "815-345-3400",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "LCPC"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Professional",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "261QM0850X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adult Mental Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QM0855X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adolescent and Children Mental Health",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Woodstock, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 23, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.