Kathleen Golly

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

180.014264 Issued in IL

Practice address

11618 McConnell Rd
Woodstock, IL 60098-7384

Phone

(224) 400-9961

NPI assigned

Aug 14, 2023

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in IL

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Mental Health Counselor

Education

Other, 2019

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Arcadia Counseling LLCGroup PAC ID 9133568546, 2 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Arcadia Counseling LLC

  • Mental Health Counselor
  • Crystal Lake, IL
  • NPI 1861198210
  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1691971200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1691971200000",
    "number": "1174306203",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "583 CARRIAGE WAY",
            "city": "SOUTH ELGIN",
            "state": "IL",
            "postal_code": "601773292"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11618 MCCONNELL RD",
            "city": "WOODSTOCK",
            "state": "IL",
            "postal_code": "600987384",
            "telephone_number": "224-400-9961"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GOLLY",
        "first_name": "KATHLEEN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2023-08-14",
        "last_updated": "2023-08-14",
        "certification_date": "2023-08-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "IL",
            "license": "180.014264",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Dorothea Ellen Gilliland, SLP
• Linda D Glenn, PT
• Cheryl L Glombicki, CNP
• Lisa M Glosson, M.D.
• Tatiana Stephanie Gmitrovic
• Katharina Gounaris, BSW, CDVP
• Katherine J Graham, MSW, LSW
• Ashleigh Lucy Annette Gregory, BCBA
• Roger C Gronau, PHD
• Shannon Guzick, PTA

• Mental Health Counselor in Woodstock, IL
• Providers in Woodstock, 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 Aug 14, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.