Amphora Counseling, PLLC

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

Legal business name

AMPHORA COUNSELING, PLLC

Practice address

3205 N Wilke Rd Ste 102C
Arlington Heights, IL 60004-0004

Phone

(224) 349-2594

Fax

(224) 350-8500

NPI assigned

Aug 5, 2021

Last updated

Jun 13, 2022By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Stacey Griffith, LCPCNPI 1578069506

Title

Professional Counselor/Therapist

Phone

(224) 349-2594

Specialties & licenses 1

Addresses

Electronic endpoints 1

Locations

Practitioners 1

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.

• Stacey Griffith, LCPC

  • Professional Counselor
  • Oak Park, IL
  • NPI 1578069506
  NPD Authorized official

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

{
    "created_epoch": "1628121600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1655078400000",
    "number": "1003580663",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3205 N WILKE RD STE 102C",
            "city": "ARLINGTON HEIGHTS",
            "state": "IL",
            "postal_code": "600040004",
            "telephone_number": "224-349-2594",
            "fax_number": "224-350-8500"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3205 N WILKE RD STE 102C",
            "city": "ARLINGTON HEIGHTS",
            "state": "IL",
            "postal_code": "600040004",
            "telephone_number": "224-349-2594",
            "fax_number": "224-350-8500"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "AMPHORA COUNSELING, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-08-05",
        "last_updated": "2022-06-13",
        "certification_date": "2022-06-13",
        "status": "A",
        "authorized_official_last_name": "GRIFFITH",
        "authorized_official_first_name": "STACEY",
        "authorized_official_title_or_position": "PROFESSIONAL COUNSELOR/THERAPIST",
        "authorized_official_telephone_number": "224-349-2594",
        "authorized_official_credential": "LCPC"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Counselor, Professional",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "sgriffith@amphoracounseling.net",
            "affiliation": "N",
            "endpointDescription": "provider email",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "3205 N Wilke Rd Ste 102C",
            "city": "Arlington Heights",
            "state": "IL",
            "country_code": "US",
            "postal_code": "600040004",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

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• Professional Counselor in Arlington Heights, IL
• Providers in Arlington Heights, IL by specialty
• Professional Counselor in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 13, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.