Tru Divine Counseling & Wellness

Primary specialty

Mental Health Clinic/Center (Including Community Mental Health Center)Taxonomy code 261QM0801X

Legal business name

TRU DIVINE COUNSELING & WELLNESS

Practice address

118 Wilson St
Park Forest, IL 60466-1365

Phone

(630) 276-8872

NPI assigned

May 9, 2023

Last updated

May 9, 2023By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Alexia NewbernNPI 1639816465

Title

Sole Member

Phone

(630) 276-8872

Specialties & licenses 1

Addresses

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.

• Alexia Newbern, LCPC

  • Professional Counselor
  • Park Forest, IL
  • NPI 1639816465
  NPD Authorized official

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

{
    "created_epoch": "1683590400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1683590400000",
    "number": "1073203576",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "118 WILSON ST",
            "city": "PARK FOREST",
            "state": "IL",
            "postal_code": "604661365"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "118 WILSON ST",
            "city": "PARK FOREST",
            "state": "IL",
            "postal_code": "604661365",
            "telephone_number": "630-276-8872"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TRU DIVINE COUNSELING & WELLNESS",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-05-09",
        "last_updated": "2023-05-09",
        "certification_date": "2023-05-09",
        "status": "A",
        "authorized_official_last_name": "NEWBERN",
        "authorized_official_first_name": "ALEXIA",
        "authorized_official_title_or_position": "SOLE MEMBER",
        "authorized_official_telephone_number": "630-276-8872"
    },
    "taxonomies": [
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Lenae Joy Tietjens, CCC-SLP
• Nader N. Tobia, M.D.
• Tracy Townes
• Timothy Treadwell
• Tribe Works Behavioral Services, LLC
• David Tyssen, D.C.
• Universal Healthcare Staffing LLC
• Sara E Veldhuizen, LPC
• Victory Centre of Park Forest LLC
• Village of Park Forest

• Mental Health Clinic/Center (Including Community Mental Health Center) in Park Forest, IL
• Providers in Park Forest, IL by specialty
• Mental Health Clinic/Center (Including Community Mental Health Center) in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 9, 2023; 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.