Jill Renae Bomstad, LCPC

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

180011696 Issued in IL

Practice address

5850 6TH Street Frontage Rd E Ste a
Springfield, IL 62703-5194

Phone

(217) 529-5046

NPI assigned

Jan 25, 2020

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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

• Living Hope Counseling Center

  • Professional Counselor
  • Springfield, IL
  • NPI 1770600355
  NPD (past)

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

{
    "created_epoch": "1579910400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1696550400000",
    "number": "1497385785",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2516 W HARBAUER LN",
            "city": "SPRINGFIELD",
            "state": "IL",
            "postal_code": "627023449",
            "telephone_number": "217-816-3048"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5850 6TH STREET FRONTAGE RD E STE A",
            "city": "SPRINGFIELD",
            "state": "IL",
            "postal_code": "627035194",
            "telephone_number": "217-529-5046"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOMSTAD",
        "first_name": "JILL",
        "middle_name": "RENAE",
        "credential": "LCPC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-01-25",
        "last_updated": "2023-10-06",
        "certification_date": "2023-10-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "IL",
            "license": "180011696",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Theresa M Boley, CFNP
• Kody Gibson Bolk, MD
• Michelle Christine Bollinger, NP-C
• Erin Elizabeth Bolskar, MSPAS, PA-C
• Jessica Lynn Bolton, APN CPNP-PC
• Andrea Lyn Bond, AGACNP
• Latoya Bond, FNP
• Nicholas Bond
• Staci L Bonds, CNP
• Steven Kent Bone, DC

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 6, 2023; 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.