Innovative Psychology Counseling Services, Inc.

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

180008289 Issued in IL

Legal business name

INNOVATIVE PSYCHOLOGY COUNSELING SERVICES, INC.

Practice address

4318 W Crystal Lake Rd
Unit L
McHenry, IL 60050-4210

Phone

(847) 508-2016

NPI assigned

Mar 16, 2016

Organization subpart

No

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

Authorized official

Name

Mr. Donald Malczynski

Title

Chief Financial Officer

Phone

(847) 508-2016

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1458086400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1458086400000",
    "number": "1013378108",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 541",
            "city": "WONDER LAKE",
            "state": "IL",
            "postal_code": "600970541"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4318 W CRYSTAL LAKE RD",
            "address_2": "UNIT L",
            "city": "MCHENRY",
            "state": "IL",
            "postal_code": "600504210",
            "telephone_number": "847-508-2016"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "INNOVATIVE PSYCHOLOGY COUNSELING SERVICES, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-03-16",
        "last_updated": "2016-03-16",
        "status": "A",
        "authorized_official_last_name": "MALCZYNSKI",
        "authorized_official_first_name": "DONALD",
        "authorized_official_title_or_position": "CHIEF FINANCIAL OFFICER",
        "authorized_official_telephone_number": "847-508-2016",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Counselor, Professional",
            "state": "IL",
            "license": "180008289",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Professional Counselor in McHenry, IL
• Providers in McHenry, IL by specialty
• Professional Counselor in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 16, 2016; 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.