Blank Canvas Counseling Co

Primary specialty

Mental Health Clinic/Center (Including Community Mental Health Center)Taxonomy code 261QM0801X

Legal business name

BLANK CANVAS COUNSELING CO

Practice address

183 E Bethel Dr
Bourbonnais, IL 60914-1456

Phone

(815) 592-4791

NPI assigned

Mar 28, 2018

Organization subpart

No

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

Authorized official

Name

Robert Kring Jr., LCPCNPI 1275038465

Title

Mental Health Therapist

Phone

(815) 592-4791

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.

• Robert Kring Jr., LCPC

  • Professional Counselor
  • Bourbonnais, IL
  • NPI 1275038465
  NPD (past) Authorized official

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

{
    "created_epoch": "1522195200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1522195200000",
    "number": "1427553627",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 264",
            "city": "AROMA PARK",
            "state": "IL",
            "postal_code": "609100264"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "183 E BETHEL DR",
            "city": "BOURBONNAIS",
            "state": "IL",
            "postal_code": "609141456",
            "telephone_number": "815-592-4791"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BLANK CANVAS COUNSELING CO",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-03-28",
        "last_updated": "2018-03-28",
        "status": "A",
        "authorized_official_last_name": "KRING",
        "authorized_official_first_name": "ROBERT",
        "authorized_official_title_or_position": "MENTAL HEALTH THERAPIST",
        "authorized_official_telephone_number": "815-592-4791",
        "authorized_official_name_suffix": "Jr.",
        "authorized_official_credential": "LCPC"
    },
    "taxonomies": [
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kristina Marie Billadeau, LPC
• Kelsey Ann Billington, LPC
• Leanne Michelle Bishop, APN
• Clayton John Blanchette, D.C.
• Gabrielle Blanchette, MHS, CCC-SLP
• Bleu Lotus 360 LLC
• Daphne Lynn Bogenschneider, LCPC, LSOTP, LSOE
• Jeffrey Bohac, PT
• Lindsay Boillot, PT
• Syed Bokhari, M.D.

• Mental Health Clinic/Center (Including Community Mental Health Center) in Bourbonnais, IL
• Providers in Bourbonnais, IL by specialty
• Mental Health Clinic/Center (Including Community Mental Health Center) in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 28, 2018; 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.