Waterbrook Counseling Services, P.C.

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

180.008054 Issued in IL

Legal business name

WATERBROOK COUNSELING SERVICES, P.C.

Practice address

407 S Dearborn St
600C
Chicago, IL 60605-1136

Phone

(773) 559-5958

NPI assigned

Aug 22, 2012

Last updated

Aug 22, 2012By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Mr. Robert Preston Stanford, L.C.P.C.NPI 1366700155

Title

Founder/President

Phone

(773) 559-5958

Specialties & licenses 1

Addresses

Locations

Practitioners 1

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.

• Robert Preston Stanford, LCPC

  • Professional Counselor
  • Frankfort, IL
  • NPI 1366700155
  NPD (past) Authorized official

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

{
    "created_epoch": "1345593600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1345593600000",
    "number": "1326396318",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1649 W SHERWIN AVE APT 3",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606261900",
            "telephone_number": "773-559-5958"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "407 S DEARBORN ST",
            "address_2": "600C",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606051136",
            "telephone_number": "773-559-5958"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WATERBROOK COUNSELING SERVICES, P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-08-22",
        "last_updated": "2012-08-22",
        "status": "A",
        "authorized_official_last_name": "STANFORD",
        "authorized_official_first_name": "ROBERT",
        "authorized_official_middle_name": "PRESTON",
        "authorized_official_title_or_position": "FOUNDER/PRESIDENT",
        "authorized_official_telephone_number": "773-559-5958",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "L.C.P.C."
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "IL",
            "license": "180.008054",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Professional Counselor in Chicago, IL
• Providers in Chicago, IL by specialty
• Professional Counselor in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2012; 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.