Xitlali Campa

Individual provider Active NPI Professional Counselor · River Forest, IL

NPI 1043007602 · NPPES record last updated Aug 26, 2026

Key facts

NPI
1043007602
Entity type
Individual (NPI type 1)
Primary specialty
Professional Counselor 101YP2500X
License
178.021806 (IL)
Practice address
414 Clinton PL Ste 106
River Forest, IL 60305-2248
Phone
(708) 866-6766
NPI assigned
Apr 24, 2025
Sex
Female
Sole proprietor
No

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

Practice roles

OrganizationSpecialtyStatusNew patients
Garden Health Group LLC Mental Health Current
since Apr 27, 2025
Accepting new patients
Lake Behavioral Health Associates, LLC Past
since Apr 27, 2025
Accepting new patients

Locations

414 Clinton Pl
Ste 106
River Forest, IL 60305
Phone (708) 866-6766

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Professional Counselor 101YP2500X 178.021806 IL Yes
Mental Health Counselor 101YM0800X

Addresses

Primary practice location

414 Clinton PL Ste 106
River Forest, IL 60305-2248

Mailing address

414 Clinton PL
River Forest, IL 60305-2255

Other providers in River Forest, IL

All providers in River Forest, IL · Professional Counselor in Illinois

Sources for this page

Verify at the official NPI Registry.