Common Boundary Wellness Center

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

Legal business name

COMMON BOUNDARY WELLNESS CENTER

Practice address

1495 Northrock CT
Rockford, IL 61103-1233

Phone

(815) 965-1817

Fax

(815) 965-9574

NPI assigned

May 4, 2007

Last updated

Aug 22, 2020By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Renee A McArdle, PSY. D.NPI 1730258898

Title

Managing Partner

Phone

(815) 965-1817

Specialties & licenses 1

Addresses

Locations

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.

• Renee A McArdle Sr., PSY.D.

  • Psychologist
  • Rockford, IL
  • NPI 1730258898
  Authorized official Same address or phone

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

{
    "created_epoch": "1178236800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1619189594",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1495 NORTHROCK CT",
            "city": "ROCKFORD",
            "state": "IL",
            "postal_code": "611031233",
            "telephone_number": "815-965-1817",
            "fax_number": "815-965-9574"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1495 NORTHROCK CT",
            "city": "ROCKFORD",
            "state": "IL",
            "postal_code": "611031233",
            "telephone_number": "815-965-1817",
            "fax_number": "815-965-9574"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COMMON BOUNDARY WELLNESS CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-05-04",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "MCARDLE",
        "authorized_official_first_name": "RENEE",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "MANAGING PARTNER",
        "authorized_official_telephone_number": "815-965-1817",
        "authorized_official_credential": "PSY. D."
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Carol Jean Collins Burchardt, LCPC
• Chelsea J Collins, RN
• Heather Collman, PT, DPT
• Carlie R Combs, PA-C
• Lydia Jane Combs, NP
• Community Care Systems, Inc
• Community Kitchen, Inc.
• Community Kitchen, Inc.
• Lori Compton
• Lenore C Conboy, R.D.

• Mental Health Counselor in Rockford, IL
• Providers in Rockford, IL by specialty
• Mental Health Counselor in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.