Bauman Psychotherapy Collaborations, LLC

Primary specialty

Adult Mental Health Clinic/CenterTaxonomy code 261QM0850X

Legal business name

BAUMAN PSYCHOTHERAPY COLLABORATIONS, LLC

Practice address

457 Coventry LN Ste 115
Crystal Lake, IL 60014-7571

Phone

(815) 245-4825

Fax

(815) 596-1008

NPI assigned

Jul 13, 2021

Organization subpart

No

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

Authorized official

Name

Kelly Jean Bauman, PSY.D; LMFT (OWNER)NPI 1174802730

Title

Owner

Phone

(815) 245-4825

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in IL

Enrollment records 1

Locations

Practitioners 1

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

• Kelly Bauman, PSY.D

  • Clinical Psychologist
  • Crystal Lake, IL
  • NPI 1174802730
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1626134400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1636934400000",
    "number": "1235701905",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "720 S EASTWOOD DR # 168",
            "city": "WOODSTOCK",
            "state": "IL",
            "postal_code": "600984635",
            "telephone_number": "815-245-4825"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "457 COVENTRY LN STE 115",
            "city": "CRYSTAL LAKE",
            "state": "IL",
            "postal_code": "600147571",
            "telephone_number": "815-245-4825",
            "fax_number": "815-596-1008"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BAUMAN PSYCHOTHERAPY COLLABORATIONS, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-07-13",
        "last_updated": "2021-11-15",
        "certification_date": "2021-11-15",
        "status": "A",
        "authorized_official_last_name": "BAUMAN",
        "authorized_official_first_name": "KELLY",
        "authorized_official_middle_name": "JEAN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "815-245-4825",
        "authorized_official_credential": "PSY.D; LMFT  (OWNER)"
    },
    "taxonomies": [
        {
            "code": "261QM0850X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adult Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Robert J. Bartucci, M.D.
• Robert Henry Basile, DMD
• Heather Marie Bassett, LSW
• Michelle A Bate, NP
• Luann Bauer
• Kelly Bauman, PSY.D
• Mikayla Bavaro, LSW
• Honeid Mohsin Baxamusa, M.D.
• Rahil Baxamusa, DPM
• Richard Joseph Bayram III

• Adult Mental Health Clinic/Center in Crystal Lake, IL
• Providers in Crystal Lake, IL by specialty
• Adult Mental Health Clinic/Center in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 15, 2021; 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.