Organization Active NPI

Independence Health & Therapy

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Woodstock, IL
National Provider Identifier
1376009753
Registry record updated Apr 27, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health Clinic/Center (Including Community Mental Health Center)Taxonomy code 261QM0801X
Legal business name
INDEPENDENCE HEALTH & THERAPY
Practice address
708 Washington St
Woodstock, IL 60098-2265
Phone
(815) 338-1707
NPI assigned
Feb 11, 2019
Organization subpart
Yes
Parent organization
INDEPENDENCE HEALTH & THERAPYAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Apr 27, 2023

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

Authorized official

Name
Mary Fisher
Title
Finance Director
Phone
(815) 338-3590

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health CounselorGroup: 193200000X MULTI-SPECIALTY GROUP 101YM0800X
Clinical Social WorkerGroup: 193200000X MULTI-SPECIALTY GROUP 1041C0700X
Mental Health Clinic/Center (Including Community Mental Health Center) 261QM0801X Primary

Addresses

Primary practice location

708 Washington St
Woodstock, IL 60098-2265

Mailing address

2028 N Seminary Ave
Woodstock, IL 60098-2626
Phone (815) 338-3590

National Provider Directory

National Provider Directory
Tax ID family
Family Alliance Inc4 organizations share this tax ID, including this one
Part of
Family Alliance Inc

Other organizations with this tax ID 3

Organizations that report the same tax identification number in the National Provider Directory.

Locations

708 Washington St
Woodstock, IL 60098
Phone (815) 338-1707

NPI Registry JSON

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

{
    "created_epoch": "1549843200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1682553600000",
    "number": "1376009753",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2028 N SEMINARY AVE",
            "city": "WOODSTOCK",
            "state": "IL",
            "postal_code": "600982626",
            "telephone_number": "815-338-3590"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "708 WASHINGTON ST",
            "city": "WOODSTOCK",
            "state": "IL",
            "postal_code": "600982265",
            "telephone_number": "815-338-1707"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "INDEPENDENCE HEALTH & THERAPY",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "INDEPENDENCE HEALTH & THERAPY",
        "enumeration_date": "2019-02-11",
        "last_updated": "2023-04-27",
        "certification_date": "2023-04-27",
        "status": "A",
        "authorized_official_last_name": "FISHER",
        "authorized_official_first_name": "MARY",
        "authorized_official_title_or_position": "FINANCE DIRECTOR",
        "authorized_official_telephone_number": "815-338-3590"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Woodstock, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 27, 2023; 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.