NPIMap

Organization Active NPI

Human Support Services

  • Mental Health Counselor
  • Waterloo, IL
National Provider Identifier
1437586112
Registry record updated Sep 26, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
Legal business name
HUMAN SUPPORT SERVICES
Practice address
224 N Main St Rear
Waterloo, IL 62298-1264
Phone
(618) 939-4444
Fax
(618) 939-4181
NPI assigned
Sep 26, 2013
Organization subpart
Yes
Parent organization
HUMAN SUPPORT SERVICESAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Sep 26, 2013

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

Authorized official

Name
Mr. Robert Cole
Title
Executive Director
Phone
(618) 939-4444

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health CounselorGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 101YM0800X Primary

Addresses

Primary practice location

224 N Main St Rear
Waterloo, IL 62298-1264

Mailing address

PO Box 146
Waterloo, IL 62298-0146
Phone (618) 939-4444

Other identifiers 2

IdentifierTypeStateIssuer
06715560OtherILBCBS
10B862OtherMOBCBS

National Provider Directory

National Provider Directory
Tax ID family
Human Support Services18 organizations share this tax ID, including this one
Part of
Human Support Services

Other organizations with this tax ID 17

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

View all 17

NPI Registry JSON

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

{
    "created_epoch": "1380153600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1380153600000",
    "number": "1437586112",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 146",
            "city": "WATERLOO",
            "state": "IL",
            "postal_code": "622980146",
            "telephone_number": "618-939-4444",
            "fax_number": "618-939-4181"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "224 N MAIN ST REAR",
            "city": "WATERLOO",
            "state": "IL",
            "postal_code": "622981264",
            "telephone_number": "618-939-4444",
            "fax_number": "618-939-4181"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HUMAN SUPPORT SERVICES",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "HUMAN SUPPORT SERVICES",
        "enumeration_date": "2013-09-26",
        "last_updated": "2013-09-26",
        "status": "A",
        "authorized_official_last_name": "COLE",
        "authorized_official_first_name": "ROBERT",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "618-939-4444",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "06715560",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "10B862",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Waterloo, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 26, 2013; 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.