Brain Dynamics LLC

Primary specialty

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

Legal business name

BRAIN DYNAMICS LLC

Practice address

746 West Spring Street
South Elgin, IL 60177-1424

Phone

(224) 801-2760

NPI assigned

Jan 9, 2024

Organization subpart

No

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

Authorized official

Name

Melissa ColonNPI 1528424512

Title

Owner/Psychologist

Phone

(224) 801-2760

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in IL

Enrollment records 1

Practitioners 1

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

• Melissa Ann Colon, PSYD

  • Clinical Psychologist
  • Lake Zurich, IL
  • NPI 1528424512
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1704758400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1704758400000",
    "number": "1194596122",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "830 W IL ROUTE 22 # 76",
            "city": "LAKE ZURICH",
            "state": "IL",
            "postal_code": "600472560",
            "telephone_number": "224-801-2760"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "746 WEST SPRING STREET",
            "city": "SOUTH ELGIN",
            "state": "IL",
            "postal_code": "601771424",
            "telephone_number": "224-801-2760"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BRAIN DYNAMICS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-01-09",
        "last_updated": "2024-01-09",
        "certification_date": "2023-12-26",
        "status": "A",
        "authorized_official_last_name": "COLON",
        "authorized_official_first_name": "MELISSA",
        "authorized_official_title_or_position": "OWNER/PSYCHOLOGIST",
        "authorized_official_telephone_number": "224-801-2760"
    },
    "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": []
}

• Jillene Bjorklund
• Matthew R Bluemlein, O.D.
• Mary Beth Bohm, MSW
• BR Health LLC
• Brady Steps PLLC
• Brandon & Associates Physical Therapy
• Matthew J Brandon, M.D.
• Brandy Lochen, LCPC, Lasop
• Briarwood Medical Center
• Jason Randall Brim, D.C.

• Mental Health Clinic/Center (Including Community Mental Health Center) in South Elgin, IL
• Providers in South Elgin, 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 Jan 9, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.