Galena River Counseling and Retreats

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

Legal business name

GALENA RIVER COUNSELING AND RETREATS

Practice address

800 Spring St Ste 101
Galena, IL 61036-2003

Phone

(773) 454-9176

NPI assigned

Sep 10, 2024

Organization subpart

No

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

Authorized official

Name

Thomas John Dennis, LCPCNPI 1285800318

Title

Member

Phone

(773) 454-9176

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in IL

Enrollment records 1

Practitioners 1

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

• Thomas John Dennis, LCPC

  • Professional Counselor
  • Galena, IL
  • NPI 1285800318

  IL, Professional

  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1725926400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1727654400000",
    "number": "1629804356",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 CAYUGA TRL",
            "city": "GALENA",
            "state": "IL",
            "postal_code": "610369430",
            "telephone_number": "773-454-9176"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "800 SPRING ST STE 101",
            "city": "GALENA",
            "state": "IL",
            "postal_code": "610362003",
            "telephone_number": "773-454-9176"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GALENA RIVER COUNSELING AND RETREATS",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-09-10",
        "last_updated": "2024-09-30",
        "certification_date": "2024-09-30",
        "status": "A",
        "authorized_official_last_name": "DENNIS",
        "authorized_official_first_name": "THOMAS",
        "authorized_official_middle_name": "JOHN",
        "authorized_official_title_or_position": "MEMBER",
        "authorized_official_telephone_number": "773-454-9176",
        "authorized_official_credential": "LCPC"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Counselor, Professional",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• All providers in Galena, IL
• Professional Counselor in Illinois

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