Individual provider Active NPI

David Welch, LCPC

  • Professional Counselor
  • Crystal Lake, IL
National Provider Identifier
1063582047
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
Practice address
390 E Congress Pkwy
Suite J
Crystal Lake, IL 60014-6202
Phone
(815) 356-5050
Fax
(815) 356-5094
NPI assigned
Nov 8, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Professional Counselor 101YP2500X IL Primary

Addresses

Primary practice location

390 E Congress Pkwy
Suite J
Crystal Lake, IL 60014-6202

Mailing address

1701 E. Woodfield Road
Suite 1000
Schaumburg, IL 60173-5113
Phone (815) 356-5050

Other identifiers 2

IdentifierTypeStateIssuer
320078OtherILVALUE OPTIONS GRP NUMBER
1633897OtherILBCBS GRP NUMBER

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240718001808 IL Practitioner - Mental Health Counselor 1355887092 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 1998
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

721 E Court St
Paris, IL 61944-2460
Phone (217) 465-4141

727 E Court St
Paris, IL 61944-2460
Phone (217) 465-8411

745 E Court St
Paris, IL 61944-2460
Phone (217) 466-4170

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
180-004424ILMDProfessional Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Hospital & Medical Foundation of Paris, Inc. CurrentSince Apr 29, 2024 Accepting new patients
Hospital & Medical Foundation of Paris, Inc. CurrentSince Apr 29, 2024 Accepting new patients
Teladoc Health Medical Group, P.a. Professional Current Accepting new patients
Hospital & Medical Foundation of Paris, Inc. Past Accepting new patients
Hospital & Medical Foundation of Paris, Inc. Past Accepting new patients

Locations

727 E Court St
Paris, IL 61944
Phone (217) 465-4141

721 E Court St
Paris, IL 61944
Phone (217) 465-4141

Interoperability endpoints

  • Direct secure messaging: david.welch.1@11356.direct.athenahealth.com
  • Direct secure messaging: davidwelch@tdh.allscriptsdirect.net

Organizations & group practices 5

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

NPI Registry JSON

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

{
    "created_epoch": "1162944000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1063582047",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1701 E. WOODFIELD ROAD",
            "address_2": "SUITE 1000",
            "city": "SCHAUMBURG",
            "state": "IL",
            "postal_code": "601735113",
            "telephone_number": "815-356-5050",
            "fax_number": "847-240-2418"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "390 E CONGRESS PKWY",
            "address_2": "SUITE J",
            "city": "CRYSTAL LAKE",
            "state": "IL",
            "postal_code": "600146202",
            "telephone_number": "815-356-5050",
            "fax_number": "815-356-5094"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WELCH",
        "first_name": "DAVID",
        "credential": "LCPC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-11-08",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "IL",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "VALUE OPTIONS GRP NUMBER",
            "identifier": "320078",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS GRP NUMBER",
            "identifier": "1633897",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Crystal Lake, IL

Sources for this page

Verify at the official NPI Registry.