Individual provider Active NPI

Kavita C. Bosamiya

  • Mental Health Counselor
  • Crystal Lake, IL
National Provider Identifier
1447852132
Registry record updated Apr 15, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
178.018183 Issued in IL
Practice address
741 S McHenry Ave Ste C
Crystal Lake, IL 60014-7445
Phone
(224) 650-6788
NPI assigned
Nov 9, 2020
Last updated
Apr 15, 2026By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 15, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X 178.018183 IL Primary

Addresses

Primary practice location

741 S McHenry Ave Ste C
Crystal Lake, IL 60014-7445

Mailing address

265 Stonegate Rd Ste 102
Algonquin, IL 60102-5614
Phone (246) 787-9180

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20251029000428 IL Practitioner - Mental Health Counselor 0547759771 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 2002
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Sloka Therapy Group PCGroup PAC ID 6204360720, 2 clinicians

Practice addresses (Care Compare)

741 S McHenry Ave
Suite C
Crystal Lake, IL 60014-7445
Phone (224) 650-6788

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
178.018183ILMDMental Health Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Epp Advisory Group, Inc. Mental Health CurrentSince Jun 1, 2025 Accepting new patients
Affective Counseling Inc Professional CurrentSince Sep 11, 2025 Accepting new patients

Locations

265 Stonegate Rd
Ste 102
Algonquin, IL 60102
Phone (224) 232-7482

111 Lions Dr
Ste 201
Barrington, IL 60010
Phone (224) 655-2655

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1604880000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1776211200000",
    "number": "1447852132",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "265 STONEGATE RD STE 102",
            "city": "ALGONQUIN",
            "state": "IL",
            "postal_code": "601025614",
            "telephone_number": "246-787-9180"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "741 S MCHENRY AVE STE C",
            "city": "CRYSTAL LAKE",
            "state": "IL",
            "postal_code": "600147445",
            "telephone_number": "224-650-6788"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOSAMIYA",
        "first_name": "KAVITA",
        "middle_name": "C.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-11-09",
        "last_updated": "2026-04-15",
        "certification_date": "2026-04-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "IL",
            "license": "178.018183",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Crystal Lake, IL

Sources for this page

Verify at the official NPI Registry.