Telos Health and Wellness Services, LLC

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

Legal business name

TELOS HEALTH AND WELLNESS SERVICES, LLC

Practice address

100 N Chestnut St.
Ste 235
Champaign, IL 61820-4872

Phone

(217) 292-7262

Fax

(217) 209-5798

NPI assigned

Aug 3, 2020

Last updated

Dec 8, 2025By 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

Mrs. Marissa Jonal Harris, LCSWNPI 1659410082

Title

Clinical Counselor

Phone

(217) 898-5160

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in IL

Enrollment records 1

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.

• Marissa Harris, LCSW

  • Clinical Social Worker
  • Danville, IL
  • NPI 1659410082
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1596412800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1765152000000",
    "number": "1336759620",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2005 N. PROSPECT AVE PMB 1178",
            "city": "CHAMPAIGN",
            "state": "IL",
            "postal_code": "618221235",
            "telephone_number": "217-292-7262",
            "fax_number": "217-209-5798"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 N CHESTNUT ST.",
            "address_2": "STE 235",
            "city": "CHAMPAIGN",
            "state": "IL",
            "postal_code": "618204872",
            "telephone_number": "217-292-7262",
            "fax_number": "217-209-5798"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "100 N Chestnut St Ste 235",
            "address_purpose": "LOCATION",
            "city": "Champaign",
            "state": "IL",
            "postal_code": "618204872",
            "country_code": "US",
            "telephone_number": "217-292-7262",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "TELOS HEALTH AND WELLNESS SERVICES, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-08-03",
        "last_updated": "2025-12-08",
        "certification_date": "2025-12-08",
        "status": "A",
        "authorized_official_last_name": "HARRIS",
        "authorized_official_first_name": "MARISSA",
        "authorized_official_middle_name": "JONAL",
        "authorized_official_title_or_position": "CLINICAL COUNSELOR",
        "authorized_official_telephone_number": "217-898-5160",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "LCSW"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Laurie Taylor
• Misty Dawn Taylor, BS/MHP
• Robert Charles Taylor, LCSW
• Timothy Neal Taylor, MS ED., LCPC
• Sololeya Teklehaimanot, LCSW
• Diojanae Terry
• Amber Nicole Tesman, RSA
• Anthony Testin, PT
• Jessica R Teymouri, AUD
• Snigdha Thakur

• Clinical Social Worker in Champaign, IL
• Providers in Champaign, IL by specialty
• Clinical Social Worker in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 8, 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.