NPIMap

Organization Active NPI

The Lodestone Center for Behavioral Health, PC

  • Psychologist
  • Woodstock, IL
National Provider Identifier
1619448222
Registry record updated Apr 30, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
Legal business name
THE LODESTONE CENTER FOR BEHAVIORAL HEALTH, PC
Practice address
111 Dean St
Woodstock, IL 60098-3220
Phone
(815) 344-5061
NPI assigned
Dec 7, 2018
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 30, 2019

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

Authorized official

Name
Dr. Jeremy T Bidwell, PH.D.NPI 1609108703
Title
Director
Phone
(815) 344-5961

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 4

Specialty (taxonomy)CodeLicenseStatePrimary
CounselorGroup: 193200000X MULTI-SPECIALTY GROUP 101Y00000X
PsychologistGroup: 193200000X MULTI-SPECIALTY GROUP 103T00000X Primary
Clinical Social WorkerGroup: 193200000X MULTI-SPECIALTY GROUP 1041C0700X
Marriage & Family TherapistGroup: 193200000X MULTI-SPECIALTY GROUP 106H00000X

Addresses

Primary practice location

111 Dean St
Woodstock, IL 60098-3220

Mailing address

111 Dean St
Woodstock, IL 60098-3220
Phone (847) 802-4058

Other practice location 1

3923 Mercy Dr Unit F
McHenry, IL 60050-3173
Phone (847) 802-4058

Other practice location 2

645 N Michigan Ave Ste 1005
Chicago, IL 60611-2814
Phone (703) 809-7036

Other practice location 3

15 Spinning Wheel Rd Ste 426
Hinsdale, IL 60521-7671
Phone (847) 802-4058

Other practice location 4

1011 Lake St Ste 421
Oak Park, IL 60301-1129
Phone (847) 802-4058

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20190501001853 IL Part B Supplier - Clinic/Group Practice 6709128317 Receives reassigned benefits from 31 practitioners
Practice locations: Hinsdale, IL; Woodstock, IL

National Provider Directory

National Provider Directory

Locations

3923 Mercy Dr
Unit F
McHenry, IL 60050
Phone (815) 344-5061

1011 Lake St
Ste 421
Oak Park, IL 60301
Phone (708) 303-8083

111 Dean St
Woodstock, IL 60098
Phone (815) 344-5061

Practitioners & affiliated clinicians

Practitioners 40

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.

View all 40

NPI Registry JSON

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

{
    "created_epoch": "1544140800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1556582400000",
    "number": "1619448222",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "111 DEAN ST",
            "city": "WOODSTOCK",
            "state": "IL",
            "postal_code": "600983220",
            "telephone_number": "847-802-4058"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "111 DEAN ST",
            "city": "WOODSTOCK",
            "state": "IL",
            "postal_code": "600983220",
            "telephone_number": "815-344-5061"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3923 Mercy Dr Unit F",
            "address_purpose": "LOCATION",
            "city": "McHenry",
            "state": "IL",
            "postal_code": "600503173",
            "country_code": "US",
            "telephone_number": "847-802-4058",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "645 N Michigan Ave Ste 1005",
            "address_purpose": "LOCATION",
            "city": "Chicago",
            "state": "IL",
            "postal_code": "606112814",
            "country_code": "US",
            "telephone_number": "703-809-7036",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "15 Spinning Wheel Rd Ste 426",
            "address_purpose": "LOCATION",
            "city": "Hinsdale",
            "state": "IL",
            "postal_code": "605217671",
            "country_code": "US",
            "telephone_number": "847-802-4058",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1011 Lake St Ste 421",
            "address_purpose": "LOCATION",
            "city": "Oak Park",
            "state": "IL",
            "postal_code": "603011129",
            "country_code": "US",
            "telephone_number": "847-802-4058",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "THE LODESTONE CENTER FOR BEHAVIORAL HEALTH, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-12-07",
        "last_updated": "2019-04-30",
        "status": "A",
        "authorized_official_last_name": "BIDWELL",
        "authorized_official_first_name": "JEREMY",
        "authorized_official_middle_name": "T",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "815-344-5961",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PH.D."
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "103T00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychologist",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "106H00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Marriage & Family Therapist",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Woodstock, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 30, 2019; 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.