Integrative Group Psychological Services, LLC

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

180010617 Issued in IL

Legal business name

INTEGRATIVE GROUP PSYCHOLOGICAL SERVICES, LLC

Practice address

25663 W Brooks Farm Rd
Round Lake, IL 60073-5250

Phone

(847) 322-2975

NPI assigned

May 27, 2018

Organization subpart

No

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

Authorized official

Name

Mrs. Diane M Bailey Yoder, LCPC, NCC

Title

Owner

Phone

(847) 322-2975

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1527379200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1527379200000",
    "number": "1285125138",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "25663 W BROOKS FARM RD",
            "city": "ROUND LAKE",
            "state": "IL",
            "postal_code": "600735250",
            "telephone_number": "847-322-2975"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "25663 W BROOKS FARM RD",
            "city": "ROUND LAKE",
            "state": "IL",
            "postal_code": "600735250",
            "telephone_number": "847-322-2975"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "INTEGRATIVE GROUP PSYCHOLOGICAL SERVICES, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-05-27",
        "last_updated": "2018-05-27",
        "status": "A",
        "authorized_official_last_name": "BAILEY YODER",
        "authorized_official_first_name": "DIANE",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "847-322-2975",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "LCPC, NCC"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Counselor, Professional",
            "state": "IL",
            "license": "180010617",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Professional Counselor in Round Lake, IL
• Providers in Round Lake, IL by specialty
• Professional Counselor in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 27, 2018; 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.