Talbularasa Wellness Center LLC

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

Legal business name

TALBULARASA WELLNESS CENTER LLC

Practice address

2255 N Greenbay Rd
Waukegan, IL 60087-6008

Phone

(224) 430-8109

NPI assigned

Mar 15, 2021

Last updated

Jul 15, 2021By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Ms. Kimerly Barkus, LCPC, CADC

Title

Licensed Therapist/Owner

Phone

(224) 430-8109

Specialties & licenses 4

Addresses

Other names 1

• Kimerly Barkus Other name

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Kim Barkus, LCPC, CADC

  • Professional Counselor
  • Gurnee, IL
  • NPI 1912253659
  NPD

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

{
    "created_epoch": "1615766400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1626307200000",
    "number": "1457936031",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 122",
            "city": "GURNEE",
            "state": "IL",
            "postal_code": "600310122",
            "telephone_number": "224-430-8109"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2255 N GREENBAY RD",
            "city": "WAUKEGAN",
            "state": "IL",
            "postal_code": "600876008",
            "telephone_number": "224-430-8109"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TALBULARASA WELLNESS CENTER LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-03-15",
        "last_updated": "2021-07-15",
        "certification_date": "2021-07-15",
        "status": "A",
        "authorized_official_last_name": "BARKUS",
        "authorized_official_first_name": "KIMERLY",
        "authorized_official_title_or_position": "LICENSED THERAPIST/OWNER",
        "authorized_official_telephone_number": "224-430-8109",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "LCPC, CADC"
    },
    "taxonomies": [
        {
            "code": "261QM0850X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adult Mental Health",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "261QM0855X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adolescent and Children Mental Health",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Kimerly Barkus",
            "code": "5",
            "type": "Other Name"
        },
        {
            "organization_name": "Kimerly Barkus",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

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• Professional Counselor in Waukegan, IL
• Providers in Waukegan, IL by specialty
• Professional Counselor in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 15, 2021; 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.