Intentional Fulfillment Counseling L.L.C.

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

Legal business name

INTENTIONAL FULFILLMENT COUNSELING L.L.C.

Practice address

429 N Weber Rd # 405
Romeoville, IL 60446-3902

Phone

(779) 242-9571

NPI assigned

Dec 14, 2020

Organization subpart

No

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

Authorized official

Name

Marissa Mitchell, LCSWNPI 1457905176

Title

Licensed Clinical Social Worker

Phone

(779) 242-9571

Specialties & licenses 1

Addresses

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Marissa Mitchell, LCSW

  • Clinical Social Worker
  • Joliet, IL
  • NPI 1457905176

  Single Specialty

  NPD Authorized official

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

{
    "created_epoch": "1607904000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1607904000000",
    "number": "1134715238",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "429 N WEBER RD # 405",
            "city": "ROMEOVILLE",
            "state": "IL",
            "postal_code": "604463902",
            "telephone_number": "779-242-9571"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "429 N WEBER RD # 405",
            "city": "ROMEOVILLE",
            "state": "IL",
            "postal_code": "604463902",
            "telephone_number": "779-242-9571"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "INTENTIONAL FULFILLMENT COUNSELING L.L.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-12-14",
        "last_updated": "2020-12-14",
        "certification_date": "2020-12-14",
        "status": "A",
        "authorized_official_last_name": "MITCHELL",
        "authorized_official_first_name": "MARISSA",
        "authorized_official_title_or_position": "LICENSED CLINICAL SOCIAL WORKER",
        "authorized_official_telephone_number": "779-242-9571",
        "authorized_official_credential": "LCSW"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Individual Advocacy Group, Inc.
• Infiniti Health Center LLC
• Margaret Ingram, LCSW
• Integrated Health of Romeoville LLC
• Integrative Health Associates, LTD
• Mehr P Iqbal, M.D.
• Latasha Jackson, RN
• Mallory Janowski
• Paula Marie Jensen Hallahan, M.A.
• Alyson Johnson, LCSW

• Mental Health Counselor in Romeoville, IL
• Providers in Romeoville, IL by specialty
• Mental Health Counselor in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 14, 2020; 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.