NPIMap

Organization Active NPI

Mind Balance, Inc

  • Professional Counselor
  • Oak Park, IL
National Provider Identifier
1366850992
Registry record updated Jul 28, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
180009210 Issued in IL
Legal business name
MIND BALANCE, INC
Practice address
115 N Marion St
Suite 1
Oak Park, IL 60301-1503
Phone
(708) 834-0909
NPI assigned
Jul 28, 2014
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 28, 2014

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

Authorized official

Name
Rose LawrenceNPI 1336489269
Title
Ceo
Phone
(708) 834-0909

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: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 101YP2500X 180009210 IL Primary

Addresses

Primary practice location

115 N Marion St
Suite 1
Oak Park, IL 60301-1503

Mailing address

115 N Marion St
Suite 1
Oak Park, IL 60301-1503
Phone (708) 834-0909

National Provider Directory

National Provider Directory

Locations

115 N Marion St
Ste 1
Oak Park, IL 60301
Phone (708) 834-0909

Practitioners & affiliated clinicians

Practitioners 2

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": "1406505600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1406505600000",
    "number": "1366850992",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "115 N MARION ST",
            "address_2": "SUITE 1",
            "city": "OAK PARK",
            "state": "IL",
            "postal_code": "603011503",
            "telephone_number": "708-834-0909"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "115 N MARION ST",
            "address_2": "SUITE 1",
            "city": "OAK PARK",
            "state": "IL",
            "postal_code": "603011503",
            "telephone_number": "708-834-0909"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MIND BALANCE, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-07-28",
        "last_updated": "2014-07-28",
        "status": "A",
        "authorized_official_last_name": "LAWRENCE",
        "authorized_official_first_name": "ROSE",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "708-834-0909"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Counselor, Professional",
            "state": "IL",
            "license": "180009210",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Oak Park, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 28, 2014; 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.