NPIMap

Organization Active NPI

In Sight Wellness LLC

  • Mental Health Counselor
  • Inverness, IL
National Provider Identifier
1497324545
Registry record updated Jun 23, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
Legal business name
IN SIGHT WELLNESS LLC
Practice address
1608 W Colonial Pkwy Ste 104
Inverness, IL 60067-4755
Phone
(331) 481-9805
NPI assigned
Jun 23, 2021
Last updated
Jun 23, 2021By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 23, 2021

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

Authorized official

Name
Sergio Garcia, LCPCNPI 1053643585
Title
Owner
Phone
(331) 481-9805

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X Primary

Addresses

Primary practice location

1608 W Colonial Pkwy Ste 104
Inverness, IL 60067-4755

Mailing address

27 Algonquin Dr Apt 1
Indianhead PK, IL 60525-9085
Phone (331) 481-9805

Other identifiers 1

IdentifierTypeStateIssuer
330727504001MedicaidIL

Electronic endpoints 1

TypeEndpointUseAffiliation
CONNECT URL MCP Health Information Exchange (HIE)

National Provider Directory

National Provider Directory

Locations

1608 W Colonial Pkwy
Ste 104
Inverness, IL 60067
Phone (331) 481-9805

Practitioners & affiliated clinicians

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.

NPI Registry JSON

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

{
    "created_epoch": "1624406400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1624406400000",
    "number": "1497324545",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "27 ALGONQUIN DR APT 1",
            "city": "INDIANHEAD PK",
            "state": "IL",
            "postal_code": "605259085",
            "telephone_number": "331-481-9805"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1608 W COLONIAL PKWY STE 104",
            "city": "INVERNESS",
            "state": "IL",
            "postal_code": "600674755",
            "telephone_number": "331-481-9805"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "IN SIGHT WELLNESS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-06-23",
        "last_updated": "2021-06-23",
        "certification_date": "2021-06-23",
        "status": "A",
        "authorized_official_last_name": "GARCIA",
        "authorized_official_first_name": "SERGIO",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "331-481-9805",
        "authorized_official_credential": "LCPC"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "330727504001",
            "state": "IL"
        }
    ],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "MCP",
            "affiliation": "N",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "1608 W Colonial Pkwy Ste 104",
            "city": "Inverness",
            "state": "IL",
            "country_code": "US",
            "postal_code": "600674755",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Inverness, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 23, 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.