Organization Active NPI

Wellbound Counseling

  • Mental Health Counselor
  • Highland Park, IL
National Provider Identifier
1336961507
Registry record updated Oct 29, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
Legal business name
WELLBOUND COUNSELING
Practice address
508 Central Ave
Suite 210
Highland Park, IL 60035
Phone
(847) 780-0055
Fax
(847) 615-0248
NPI assigned
Oct 29, 2024
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 29, 2024

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

Authorized official

Name
Mr. Anthony Iacubino, LCPCNPI 1588635445
Title
Owner, Clinical Director
Phone
(847) 668-5660

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
Mental Health CounselorGroup: 193400000X SINGLE SPECIALTY GROUP 101YM0800X Primary

Addresses

Primary practice location

508 Central Ave
Suite 210
Highland Park, IL 60035

Mailing address

1344 Burr Oak. Rd.
Lake Forest, IL 60045
Phone (847) 668-5660

National Provider Directory

National Provider Directory

Locations

508 Central Ave
Ste 210
Highland Park, IL 60035
Phone (847) 780-0055

Practitioners & affiliated clinicians

Practitioners 1

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

NPI Registry JSON

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

{
    "created_epoch": "1730160000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1730160000000",
    "number": "1336961507",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1344 BURR OAK. RD.",
            "city": "LAKE FOREST",
            "state": "IL",
            "postal_code": "60045",
            "telephone_number": "847-668-5660",
            "fax_number": "847-615-0248"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "508 CENTRAL AVE",
            "address_2": "SUITE 210",
            "city": "HIGHLAND PARK",
            "state": "IL",
            "postal_code": "60035",
            "telephone_number": "847-780-0055",
            "fax_number": "847-615-0248"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WELLBOUND COUNSELING",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-10-29",
        "last_updated": "2024-10-29",
        "certification_date": "2024-10-17",
        "status": "A",
        "authorized_official_last_name": "IACUBINO",
        "authorized_official_first_name": "ANTHONY",
        "authorized_official_title_or_position": "OWNER, CLINICAL DIRECTOR",
        "authorized_official_telephone_number": "847-668-5660",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "LCPC"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Highland Park, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 29, 2024; 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.