NPIMap

Organization Active NPI

Wellspire Counseling PLLC

  • Clinical Psychologist
  • Chicago, IL
National Provider Identifier
1609594415
Registry record updated Feb 20, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
Legal business name
WELLSPIRE COUNSELING PLLC
Practice address
4421 N Wolcott Ave Apt 1a
Chicago, IL 60640-5868
Phone
(440) 668-1276
NPI assigned
Aug 17, 2022
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 20, 2025

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

Authorized official

Name
Dr. Jill R Vance, PSYDNPI 1265103527
Title
Owner
Phone
(440) 668-1276

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 3

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health CounselorGroup: 193200000X MULTI-SPECIALTY GROUP 101YM0800X
Professional CounselorGroup: 193200000X MULTI-SPECIALTY GROUP 101YP2500X
Clinical PsychologistGroup: 193200000X MULTI-SPECIALTY GROUP 103TC0700X Primary

Addresses

Primary practice location

4421 N Wolcott Ave Apt 1a
Chicago, IL 60640-5868

Mailing address

26310 N Woodland Rd
Beachwood, OH 44122-1747
Phone (440) 668-1276

Other practice location 1

26310 N Woodland Rd
Beachwood, OH 44122-1747
Phone (440) 668-1276

Other identifiers 1

IdentifierTypeStateIssuer
1265103527OtherINDIVIDUAL NPI

Electronic endpoints 1

TypeEndpointUseAffiliation
CONNECT URL https://doxy.me/jillvancepsyd

National Provider Directory

National Provider Directory
Tax ID family
Mentella Health2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

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

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": "1660694400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1740009600000",
    "number": "1609594415",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "26310 N WOODLAND RD",
            "city": "BEACHWOOD",
            "state": "OH",
            "postal_code": "441221747",
            "telephone_number": "440-668-1276"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4421 N WOLCOTT AVE APT 1A",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606405868",
            "telephone_number": "440-668-1276"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "26310 N Woodland Rd",
            "address_purpose": "LOCATION",
            "city": "Beachwood",
            "state": "OH",
            "postal_code": "441221747",
            "country_code": "US",
            "telephone_number": "440-668-1276",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "WELLSPIRE COUNSELING PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-08-17",
        "last_updated": "2025-02-20",
        "certification_date": "2025-02-20",
        "status": "A",
        "authorized_official_last_name": "VANCE",
        "authorized_official_first_name": "JILL",
        "authorized_official_middle_name": "R",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "440-668-1276",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PSYD"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Professional",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychologist, Clinical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "INDIVIDUAL NPI",
            "identifier": "1265103527",
            "state": null
        }
    ],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "https://doxy.me/jillvancepsyd",
            "affiliation": "N",
            "address_1": "4421 N Wolcott Ave Apt 1A",
            "city": "Chicago",
            "state": "IL",
            "country_code": "US",
            "postal_code": "606405868",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Chicago, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 20, 2025; 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.