Organization Active NPI

Fully Alive Counseling PLLC

  • Professional Counselor
  • Olney, IL
National Provider Identifier
1245043678
Registry record updated Feb 12, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
Legal business name
FULLY ALIVE COUNSELING PLLC
Practice address
801 S West St Ste 107
Olney, IL 62450-1334
Phone
(618) 816-1126
NPI assigned
Jan 29, 2025
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 12, 2025

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

Authorized official

Name
Linda Steinbach
Title
Office Manager
Phone
(513) 356-6129

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Professional CounselorGroup: 193400000X SINGLE SPECIALTY GROUP 101YP2500X Primary

Addresses

Primary practice location

801 S West St Ste 107
Olney, IL 62450-1334

Mailing address

801 S West St Ste 107
Olney, IL 62450-1334
Phone (513) 356-6129

Other identifiers 1

IdentifierTypeStateIssuer
180.007390OtherILSTATE LICENSE

National Provider Directory

National Provider Directory

Locations

801 S West St
Ste 107
Olney, IL 62450
Phone (618) 816-1126

NPI Registry JSON

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

{
    "created_epoch": "1738108800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1739318400000",
    "number": "1245043678",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "801 S WEST ST STE 107",
            "city": "OLNEY",
            "state": "IL",
            "postal_code": "624501334",
            "telephone_number": "513-356-6129"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "801 S WEST ST STE 107",
            "city": "OLNEY",
            "state": "IL",
            "postal_code": "624501334",
            "telephone_number": "618-816-1126"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FULLY ALIVE COUNSELING PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-01-29",
        "last_updated": "2025-02-12",
        "certification_date": "2025-02-05",
        "status": "A",
        "authorized_official_last_name": "STEINBACH",
        "authorized_official_first_name": "LINDA",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "513-356-6129"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Counselor, Professional",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE LICENSE",
            "identifier": "180.007390",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Olney, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 12, 2025; 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.