NPIMap

Organization Active NPI

Mindful Support PLLC

  • Mental Health Counselor
  • Palatine, IL
National Provider Identifier
1003689217
Registry record updated Aug 22, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
Legal business name
MINDFUL SUPPORT PLLC
Practice address
110 N Brockway St Ste 300
Palatine, IL 60067-5063
Phone
(630) 640-3539
NPI assigned
Oct 31, 2023
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2025

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

Authorized official

Name
Veesser Aminpour PohnNPI 1215552393
Title
Clinical Manager
Phone
(312) 536-4495

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 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health CounselorGroup: 193400000X SINGLE SPECIALTY GROUP 101YM0800X Primary

Addresses

Primary practice location

110 N Brockway St Ste 300
Palatine, IL 60067-5063

Mailing address

38W463 Clubhouse Dr
St Charles, IL 60175-6178
Phone (630) 640-3539

Other names 1

  • Ellie Mental Health Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20240206004209 IL Part B Supplier - Clinic/Group Practice 3870936842 Receives reassigned benefits from 8 practitioners
Practice locations: Palatine, IL

National Provider Directory

National Provider Directory

Locations

110 N Brockway St
Ste 300
Palatine, IL 60067
Phone (847) 485-1640

Practitioners & affiliated clinicians

Practitioners 13

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

View all 13

NPI Registry JSON

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

{
    "created_epoch": "1698710400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1755820800000",
    "number": "1003689217",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "38W463 CLUBHOUSE DR",
            "city": "ST CHARLES",
            "state": "IL",
            "postal_code": "601756178",
            "telephone_number": "630-640-3539"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "110 N BROCKWAY ST STE 300",
            "city": "PALATINE",
            "state": "IL",
            "postal_code": "600675063",
            "telephone_number": "630-640-3539"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MINDFUL SUPPORT PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-10-31",
        "last_updated": "2025-08-22",
        "certification_date": "2025-08-22",
        "status": "A",
        "authorized_official_last_name": "POHN",
        "authorized_official_first_name": "VEESSER",
        "authorized_official_middle_name": "AMINPOUR",
        "authorized_official_title_or_position": "CLINICAL MANAGER",
        "authorized_official_telephone_number": "312-536-4495"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Ellie Mental Health",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Ellie Mental Health",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Palatine, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2025; 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.