Edward Groenendal, MA

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

180004527 Issued in IL

Practice address

475 W Terra Cotta Ave Ste B1
Crystal Lake, IL 60014-3407

Phone

(847) 899-8370

Fax

(815) 425-5980

NPI assigned

Aug 25, 2006

Last updated

Apr 9, 2025By the provider in NPPES

Sex

Male

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

Credentials

Master of Arts

State licenses

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

{
    "created_epoch": "1156464000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1744156800000",
    "number": "1629185475",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "475 W TERRA COTTA AVE STE B1",
            "city": "CRYSTAL LAKE",
            "state": "IL",
            "postal_code": "600143407",
            "telephone_number": "847-899-8370",
            "fax_number": "815-425-5980"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "475 W TERRA COTTA AVE STE B1",
            "city": "CRYSTAL LAKE",
            "state": "IL",
            "postal_code": "600143407",
            "telephone_number": "847-899-8370",
            "fax_number": "815-425-5980"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GROENENDAL",
        "first_name": "EDWARD",
        "name_prefix": "Mr.",
        "credential": "MA",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-08-25",
        "last_updated": "2025-04-09",
        "certification_date": "2025-04-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "IL",
            "license": "180004527",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Megan Paige Griesman, APRN
• Shareikka Lacole Griffin, PA-C
• James P Grimm, LCPC
• Paul Leonard Grindstaff, MD
• Brian Michael Griseto
• Lindsay Grosscup, NP
• Tyler Grotti, DPT
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• Gary G Gruebnau, LSW MASTERS
• Grace Page Grzybek

• Professional Counselor in Crystal Lake, IL
• Providers in Crystal Lake, IL by specialty
• Professional Counselor in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 9, 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.