NPIMap

Organization Active NPI

Blair Counseling and Mediation PC

  • Professional Counselor
  • Crystal Lake, IL
National Provider Identifier
1245479674
Registry record updated Jan 14, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
Legal business name
BLAIR COUNSELING AND MEDIATION PC
Practice address
27 Grant St
Crystal Lake, IL 60014-4372
Phone
(815) 276-3947
NPI assigned
Feb 9, 2009
Last updated
Jan 14, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 14, 2025

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

Authorized official

Name
Mr. Dan K Blair, LCPC, LMFTNPI 1891866141
Title
Owner
Phone
(815) 276-3947

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health CounselorGroup: 193200000X MULTI-SPECIALTY GROUP 101YM0800X
Professional CounselorGroup: 193200000X MULTI-SPECIALTY GROUP 101YP2500X Primary
Marriage & Family TherapistGroup: 193200000X MULTI-SPECIALTY GROUP 106H00000X

Addresses

Primary practice location

27 Grant St
Crystal Lake, IL 60014-4372

Mailing address

27 Grant St
Crystal Lake, IL 60014-4372
Phone (815) 276-3947

Other names 1

  • Blair Counseling Former legal business name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20210903000007 IL Part B Supplier - Clinic/Group Practice 9032515796 Receives reassigned benefits from 5 practitioners
Practice locations: Crystal Lake, IL

National Provider Directory

National Provider Directory

Locations

27 Grant St
Crystal Lake, IL 60014
Phone (815) 276-3947

600 Dakota St
Ste B
Crystal Lake, IL 60012
Phone (815) 276-3947

Practitioners & affiliated clinicians

Practitioners 25

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 25

NPI Registry JSON

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

{
    "created_epoch": "1234137600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1736812800000",
    "number": "1245479674",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "27 GRANT ST",
            "city": "CRYSTAL LAKE",
            "state": "IL",
            "postal_code": "600144372",
            "telephone_number": "815-276-3947"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "27 GRANT ST",
            "city": "CRYSTAL LAKE",
            "state": "IL",
            "postal_code": "600144372",
            "telephone_number": "815-276-3947"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BLAIR COUNSELING AND MEDIATION PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-02-09",
        "last_updated": "2025-01-14",
        "certification_date": "2025-01-14",
        "status": "A",
        "authorized_official_last_name": "BLAIR",
        "authorized_official_first_name": "DAN",
        "authorized_official_middle_name": "K",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "815-276-3947",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "LCPC, LMFT"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Professional",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "106H00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Marriage & Family Therapist",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Blair Counseling",
            "code": "4",
            "type": "Former Legal Business Name"
        },
        {
            "organization_name": "Blair Counseling",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

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 Jan 14, 2025; 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.