NPIMap

Organization Active NPI

Foundations Counseling, LLC

  • Clinical Social Worker
  • Evergreen Park, IL
National Provider Identifier
1124530456
Registry record updated Jul 20, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
149019762 Issued in IL
Legal business name
FOUNDATIONS COUNSELING, LLC
Practice address
9730 S Western Ave Ste 215
Evergreen Park, IL 60805
Phone
(773) 242-9726
NPI assigned
Oct 26, 2017
Last updated
Jul 20, 2018By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 20, 2018

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

Authorized official

Name
Samantha Louise Allen, MSW, LCSWNPI 1306385398
Title
Ceo/ Mental Health Therapist
Phone
(708) 529-0122

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social WorkerGroup: 193400000X SINGLE SPECIALTY GROUP 1041C0700X 149019762 IL Primary

Addresses

Primary practice location

9730 S Western Ave Ste 215
Evergreen Park, IL 60805

Mailing address

9730 S Western Ave Ste 215
Evergreen Park, IL 60805-2871

Other practice location 1

9730 S. Western Ave
Ste. 215
Evergreen Park, ID 60805
Phone (773) 242-9726

National Provider Directory

National Provider Directory

Locations

9730 S Western Ave
Ste 215
Evergreen Park, IL 60805
Phone (773) 242-9726

Practitioners & affiliated clinicians

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.

NPI Registry JSON

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

{
    "created_epoch": "1508976000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1532044800000",
    "number": "1124530456",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9730 S WESTERN AVE STE 215",
            "city": "EVERGREEN PARK",
            "state": "IL",
            "postal_code": "608052871"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9730 S WESTERN AVE STE 215",
            "city": "EVERGREEN PARK",
            "state": "IL",
            "postal_code": "60805",
            "telephone_number": "773-242-9726"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "9730 S. Western Ave",
            "address_2": "Ste. 215",
            "address_purpose": "LOCATION",
            "city": "Evergreen Park",
            "state": "ID",
            "postal_code": "60805",
            "country_code": "US",
            "telephone_number": "773-242-9726",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "FOUNDATIONS COUNSELING, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-10-26",
        "last_updated": "2018-07-20",
        "status": "A",
        "authorized_official_last_name": "ALLEN",
        "authorized_official_first_name": "SAMANTHA",
        "authorized_official_middle_name": "LOUISE",
        "authorized_official_title_or_position": "CEO/ MENTAL HEALTH THERAPIST",
        "authorized_official_telephone_number": "708-529-0122",
        "authorized_official_credential": "MSW, LCSW"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Social Worker, Clinical",
            "state": "IL",
            "license": "149019762",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Evergreen Park, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 20, 2018; 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.