Nicole Eileen Boswell, MA, LPC, NCC
Individual provider Active NPI Professional Counselor · Homer Glen, IL
NPI 1447717384 · NPPES record last updated Feb 27, 2019
Key facts
- NPI
- 1447717384
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Professional Counselor 101YP2500X
- License
- 178.014593 (IL)
- Practice address
- 13728 W Carefree Dr
Homer Glen, IL 60491-8655 - Phone
- (815) 955-8728
- Fax
- (708) 966-4244
- NPI assigned
- Feb 27, 2019
- Sex
- Female
- Sole proprietor
- Yes
Organizations & group practices 1
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
- Credentials
- Master of Arts
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 178.014593 | IL | MD | Professional Counselor |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Beyond Healing - a Counseling, Wellness & Personal Growth Center | Past | Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Professional Counselor |
101YP2500X | 178.014593 | IL | Yes |
Addresses
Primary practice location
13728 W Carefree Dr
Homer Glen, IL 60491-8655
Mailing address
425 S Roosevelt Ave Apt 11
Kankakee, IL 60901-3068
Phone (815) 341-2060
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 178.014593 | Other | IL | LICENSED PROFESSIONAL COUNSELOR |
Other names
- Nicole Pedone
Other providers in Homer Glen, IL
- Booth Orthodontics LLC
- Booth Orthodontics of Homer Glen LLP
- Barry E Booth
- Evan Booth
- Ryan Elston Booth
- Tyler Branson
- Brenczewski Physical Therapy
- Edward J. Brennan
- Derek Brown
- Maria Teresa Brutus
All providers in Homer Glen, IL · Professional Counselor in Illinois
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Feb 27, 2019. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.