Broadreach Counseling LLC

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

149.018710 Issued in IL

Legal business name

BROADREACH COUNSELING LLC

Practice address

1580 S Milwaukee Ave Ste 104
Libertyville, IL 60048-3770

Phone

(847) 636-6134

NPI assigned

Aug 8, 2017

Organization subpart

No

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

Authorized official

Name

Katherine Henoch, LCPCNPI 1861779217

Title

Co-Owner/Psychotherapist

Phone

(847) 348-9501

Specialties & licenses 2

Addresses

Other identifiers 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.

• Katherine L Henoch, MA, LPC

  • Professional Counselor
  • Libertyville, IL
  • NPI 1861779217
  NPD Authorized official

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

{
    "created_epoch": "1502150400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1510531200000",
    "number": "1063937324",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1580 S MILWAUKEE AVE STE 104",
            "city": "LIBERTYVILLE",
            "state": "IL",
            "postal_code": "600483770",
            "telephone_number": "847-348-9501",
            "fax_number": "847-264-9247"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1580 S MILWAUKEE AVE STE 104",
            "city": "LIBERTYVILLE",
            "state": "IL",
            "postal_code": "600483770",
            "telephone_number": "847-636-6134"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BROADREACH COUNSELING LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-08-08",
        "last_updated": "2017-11-13",
        "status": "A",
        "authorized_official_last_name": "HENOCH",
        "authorized_official_first_name": "KATHERINE",
        "authorized_official_title_or_position": "CO-OWNER/PSYCHOTHERAPIST",
        "authorized_official_telephone_number": "847-348-9501",
        "authorized_official_credential": "LCPC"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Professional",
            "state": "IL",
            "license": "180.010359",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Social Worker, Clinical",
            "state": "IL",
            "license": "149.018710",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "331742678001",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Patricia Bress, SLP
• Brian P Danielewicz DDS LTD
• Anastasia Brierton, DO
• Brightlife Regenerative Medical Clinic SC
• John Phillippe Broadnax, M.D.
• Richard N. Brochu, DDS
• Christianna Broton, SLP
• Browdy Home Care, Inc. (Visiting Angels Libertyville)
• Frettina Brown, MS,LPC,NCC
• Kari Jo Brown, OTR/L

• Clinical Social Worker in Libertyville, IL
• Providers in Libertyville, IL by specialty
• Clinical Social Worker in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 13, 2017; 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.