NPIMap

Organization Active NPI

Mental Health Solutions, P.C.

  • Clinical Psychologist
  • Barrington, IL
National Provider Identifier
1487891198
Registry record updated Jan 16, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
071007152 Issued in IL
Legal business name
MENTAL HEALTH SOLUTIONS, P.C.
Practice address
101 Lions Dr
Suite 115
Barrington, IL 60010-3181
Phone
(847) 566-0164
Fax
(847) 277-7235
NPI assigned
Jan 16, 2009
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 16, 2009

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

Authorized official

Name
Dr. Bright-Prophet Eternity Fellowes, PSY.D., LP
Title
President
Phone
(847) 566-0164

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical PsychologistGroup: 193200000X MULTI-SPECIALTY GROUP 103TC0700X 071007152 IL Primary

Addresses

Primary practice location

101 Lions Dr
Suite 115
Barrington, IL 60010-3181

Mailing address

101 Lions Dr
Suite 115
Barrington, IL 60010-3181
Phone (847) 566-0164

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20090416000679 IL Part B Supplier - Clinic/Group Practice 3072660646 Receives reassigned benefits from 4 practitioners
Practice locations: Mundelein, IL

National Provider Directory

National Provider Directory

Locations

101 Lions Dr
Ste 115
Barrington, IL 60010
Phone (847) 224-0195

405 Washington Blvd
Ste 201
Mundelein, IL 60060
Phone (312) 342-3380

Practitioners & affiliated clinicians

Practitioners 14

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

View all 14

NPI Registry JSON

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

{
    "created_epoch": "1232064000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1232064000000",
    "number": "1487891198",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "101 LIONS DR",
            "address_2": "SUITE 115",
            "city": "BARRINGTON",
            "state": "IL",
            "postal_code": "600103181",
            "telephone_number": "847-566-0164",
            "fax_number": "847-277-7235"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "101 LIONS DR",
            "address_2": "SUITE 115",
            "city": "BARRINGTON",
            "state": "IL",
            "postal_code": "600103181",
            "telephone_number": "847-566-0164",
            "fax_number": "847-277-7235"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MENTAL HEALTH SOLUTIONS, P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-01-16",
        "last_updated": "2009-01-16",
        "status": "A",
        "authorized_official_last_name": "FELLOWES",
        "authorized_official_first_name": "BRIGHT-PROPHET",
        "authorized_official_middle_name": "ETERNITY",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "847-566-0164",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PSY.D., LP"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychologist, Clinical",
            "state": "IL",
            "license": "071007152",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Barrington, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 16, 2009; 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.