NPIMap

Organization Active NPI

Youth & Family Counseling

  • Social Worker
  • Libertyville, IL
National Provider Identifier
1487770798
Registry record updated Apr 13, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Social WorkerTaxonomy code 104100000X
Legal business name
YOUTH & FAMILY COUNSELING
Practice address
1113 S Milwaukee Ave
Suite 104
Libertyville, IL 60048-3758
Phone
(847) 367-5991
Fax
(847) 367-5997
NPI assigned
Mar 21, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 13, 2020

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

Authorized official

Name
Mrs. Gina Tober, MA, LCPC
Title
Director of Clinical Services
Phone
(847) 748-0385

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Social WorkerGroup: 193400000X SINGLE SPECIALTY GROUP 104100000X Primary

Addresses

Primary practice location

1113 S Milwaukee Ave
Suite 104
Libertyville, IL 60048-3758

Mailing address

1113 S Milwaukee Ave
Suite 104
Libertyville, IL 60048-3758
Phone (847) 367-5991

Other names 1

  • Youth & Family Counseling Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20090623000561 IL Part B Supplier - Clinic/Group Practice 3173674678 Receives reassigned benefits from 2 practitioners
Practice locations: Lake Zurich, IL; Libertyville, IL

National Provider Directory

National Provider Directory
Tax ID family
Youth Family Counseling4 organizations share this tax ID, including this one

Other organizations with this tax ID 3

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

Locations

1585 N Milwaukee Ave
Ste 14
Libertyville, IL 60048
Phone (847) 367-5991

Practitioners & affiliated clinicians

Practitioners 6

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1174435200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1586736000000",
    "number": "1487770798",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1113 S MILWAUKEE AVE",
            "address_2": "SUITE 104",
            "city": "LIBERTYVILLE",
            "state": "IL",
            "postal_code": "600483758",
            "telephone_number": "847-367-5991",
            "fax_number": "847-367-5997"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1113 S MILWAUKEE AVE",
            "address_2": "SUITE 104",
            "city": "LIBERTYVILLE",
            "state": "IL",
            "postal_code": "600483758",
            "telephone_number": "847-367-5991",
            "fax_number": "847-367-5997"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "YOUTH & FAMILY COUNSELING",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-21",
        "last_updated": "2020-04-13",
        "certification_date": "2020-04-13",
        "status": "A",
        "authorized_official_last_name": "TOBER",
        "authorized_official_first_name": "GINA",
        "authorized_official_title_or_position": "DIRECTOR OF CLINICAL SERVICES",
        "authorized_official_telephone_number": "847-748-0385",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "MA, LCPC"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Social Worker",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Youth & Family Counseling",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Libertyville, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 13, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.