Organization Active NPI

Verdure Health LLC

  • Mental Health Counselor
  • Gurnee, IL
National Provider Identifier
1619622685
Registry record updated May 7, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
Legal business name
VERDURE HEALTH LLC
Practice address
1761 N Dilleys Rd Ste 210
Gurnee, IL 60031-1721
Phone
(224) 419-5053
NPI assigned
Feb 17, 2022
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 7, 2024

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

Authorized official

Name
Dr. Glenisha L.C. Foreman, LCPCNPI 1467062356
Title
Owner
Phone
(224) 637-6999

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 CounselorGroup: 193400000X SINGLE SPECIALTY GROUP 101YM0800X Primary

Addresses

Primary practice location

1761 N Dilleys Rd Ste 210
Gurnee, IL 60031-1721

Mailing address

1761 N Dilleys Rd Ste 210
Gurnee, IL 60031-1721
Phone (224) 419-5053

Other names 1

  • Verdure Counseling Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20240618002113 IL Part B Supplier - Clinic/Group Practice 9436692571 Receives reassigned benefits from 1 practitioner
Practice locations: Gurnee, IL

National Provider Directory

National Provider Directory

Locations

1761 N Dilleys Rd
Ste 210
Gurnee, IL 60031
Phone (224) 419-5053

2504 Washington St
Ste 300K
Waukegan, IL 60085

Practitioners & affiliated clinicians

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1645056000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1715040000000",
    "number": "1619622685",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1761 N DILLEYS RD STE 210",
            "city": "GURNEE",
            "state": "IL",
            "postal_code": "600311721",
            "telephone_number": "224-419-5053"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1761 N DILLEYS RD STE 210",
            "city": "GURNEE",
            "state": "IL",
            "postal_code": "600311721",
            "telephone_number": "224-419-5053"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "VERDURE HEALTH LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-02-17",
        "last_updated": "2024-05-07",
        "certification_date": "2024-05-07",
        "status": "A",
        "authorized_official_last_name": "FOREMAN",
        "authorized_official_first_name": "GLENISHA",
        "authorized_official_middle_name": "L.C.",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "224-637-6999",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "LCPC"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Verdure Counseling",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Verdure Counseling",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Gurnee, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 7, 2024; 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.