NPIMap

Organization Active NPI

Healing Grace Counseling, LTD.

  • Clinical Psychologist
  • Naperville, IL
National Provider Identifier
1639222920
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
Legal business name
HEALING GRACE COUNSELING, LTD.
Practice address
800 W 5TH Ave
100G
Naperville, IL 60563-8965
Phone
(312) 498-4113
Fax
(312) 630-1342
NPI assigned
Jan 19, 2007
Last updated
Aug 22, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Dr. Angela Deon Gillham, PSY.D.NPI 1194878405
Title
President
Phone
(312) 498-4113

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
Clinical Psychologist 103TC0700X IL Primary

Addresses

Primary practice location

800 W 5TH Ave
100G
Naperville, IL 60563-8965

Mailing address

800 W 5TH Ave
100G
Naperville, IL 60563-8965
Phone (312) 498-4113

Other identifiers 3

IdentifierTypeStateIssuer
2254200OtherILCIGNA
266818OtherILCOMPSYCH
2232522OtherILBLUE CROSS BLUE SHIELD

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

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.

NPI Registry JSON

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

{
    "created_epoch": "1169164800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1639222920",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "800 W 5TH AVE",
            "address_2": "100G",
            "city": "NAPERVILLE",
            "state": "IL",
            "postal_code": "605638965",
            "telephone_number": "312-498-4113",
            "fax_number": "312-630-1342"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "800 W 5TH AVE",
            "address_2": "100G",
            "city": "NAPERVILLE",
            "state": "IL",
            "postal_code": "605638965",
            "telephone_number": "312-498-4113",
            "fax_number": "312-630-1342"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HEALING GRACE COUNSELING, LTD.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-19",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "GILLHAM",
        "authorized_official_first_name": "ANGELA",
        "authorized_official_middle_name": "DEON",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "312-498-4113",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PSY.D."
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "IL",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CIGNA",
            "identifier": "2254200",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "COMPSYCH",
            "identifier": "266818",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "2232522",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Naperville, IL

Sources for this page

  • 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.