Organization Active NPI

Olive Branch Counseling Associates, Inc.

  • Professional Counselor
  • Tinley Park, IL
National Provider Identifier
1255867602
Registry record updated Apr 22, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
178.012644 Issued in IL
Legal business name
OLIVE BRANCH COUNSELING ASSOCIATES, INC.
Practice address
6819 167TH St
Tinley Park, IL 60477-2501
Phone
(708) 633-8000
NPI assigned
May 4, 2017
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 22, 2025

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

Authorized official

Name
Mrs. Louella B. Devries, LCPCNPI 1710091582
Title
President, LCPC, Ma
Phone
(708) 633-8000

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 1

Specialty (taxonomy)CodeLicenseStatePrimary
Professional CounselorGroup: 193200000X MULTI-SPECIALTY GROUP 101YP2500X 178.012644 IL Primary

Addresses

Primary practice location

6819 167TH St
Tinley Park, IL 60477-2501

Mailing address

6819 167TH St
Tinley Park, IL 60477-2501
Phone (708) 633-8000

National Provider Directory

National Provider Directory
Tax ID family
Olive Branch Counseling Associates Inc2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Practitioners & affiliated clinicians

Practitioners 15

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

View all 15

NPI Registry JSON

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

{
    "created_epoch": "1493856000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1745280000000",
    "number": "1255867602",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6819 167TH ST",
            "city": "TINLEY PARK",
            "state": "IL",
            "postal_code": "604772501",
            "telephone_number": "708-633-8000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6819 167TH ST",
            "city": "TINLEY PARK",
            "state": "IL",
            "postal_code": "604772501",
            "telephone_number": "708-633-8000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "OLIVE BRANCH COUNSELING ASSOCIATES, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-05-04",
        "last_updated": "2025-04-22",
        "certification_date": "2025-04-22",
        "status": "A",
        "authorized_official_last_name": "DEVRIES",
        "authorized_official_first_name": "LOUELLA",
        "authorized_official_middle_name": "B.",
        "authorized_official_title_or_position": "PRESIDENT, LCPC, MA",
        "authorized_official_telephone_number": "708-633-8000",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "LCPC"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Professional",
            "state": "IL",
            "license": "178.012644",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tinley Park, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 22, 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.