NPIMap

Organization Active NPI

McHenry County Mental Health Board

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Crystal Lake, IL
National Provider Identifier
1154579068
Registry record updated Sep 4, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health Clinic/Center (Including Community Mental Health Center)Taxonomy code 261QM0801X
Legal business name
MCHENRY COUNTY MENTAL HEALTH BOARD
Practice address
620 Dakota St
Crystal Lake, IL 60012-3732
Phone
(815) 455-2828
NPI assigned
Sep 4, 2008
Organization subpart
Yes
Parent organization
COUNTY OF MCHENRY ILLINOISAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Sep 4, 2008

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

Authorized official

Name
Mrs. Alexandria Lewis
Title
Executive Director
Phone
(815) 455-2828

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Clinic/Center (Including Community Mental Health Center) 261QM0801X Primary

Addresses

Primary practice location

620 Dakota St
Crystal Lake, IL 60012-3732

Mailing address

620 Dakota St
Crystal Lake, IL 60012-3732
Phone (815) 455-2828

Other identifiers 1

IdentifierTypeStateIssuer
014MedicaidIL

National Provider Directory

National Provider Directory
Tax ID family
McHenry County Mental Health Board8 organizations share this tax ID, including this one
Part of
McHenry County Mental Health Board

Other organizations with this tax ID 7

Organizations that report the same tax identification number in the National Provider Directory.

Ownership & related parties

Parent organization (reported in NPPES) 1

This organization reports itself as a subpart in NPPES; the parent’s legal name matches this organization in the same state.

NPI Registry JSON

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

{
    "created_epoch": "1220486400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1220486400000",
    "number": "1154579068",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "620 DAKOTA ST",
            "city": "CRYSTAL LAKE",
            "state": "IL",
            "postal_code": "600123732",
            "telephone_number": "815-455-2828"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "620 DAKOTA ST",
            "city": "CRYSTAL LAKE",
            "state": "IL",
            "postal_code": "600123732",
            "telephone_number": "815-455-2828"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MCHENRY COUNTY MENTAL HEALTH BOARD",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "COUNTY OF MCHENRY ILLINOIS",
        "enumeration_date": "2008-09-04",
        "last_updated": "2008-09-04",
        "status": "A",
        "authorized_official_last_name": "LEWIS",
        "authorized_official_first_name": "ALEXANDRIA",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "815-455-2828",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "014",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Crystal Lake, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 4, 2008; 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.