Mind Body Connections PLLC

Primary specialty

Clinic/CenterTaxonomy code 261Q00000X

License

180-003221 Issued in IL

Legal business name

MIND BODY CONNECTIONS PLLC

Practice address

24W788 75TH St
Naperville, IL 60565-1684

Phone

(312) 543-2133

NPI assigned

Jan 28, 2013

Last updated

Aug 19, 2023By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Stacey M Hurst, LCPCNPI 1316044860

Title

Owner

Phone

(312) 543-2133

Specialties & licenses 4

Addresses

Locations

Practitioners 2

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.

• Stacey McGinn Hurst, LCPC

  • Mental Health Counselor
  • Naperville, IL
  • NPI 1316044860
  NPD Authorized official
• Stephanie Kilper, LCPC

  • Professional Counselor
  • Chicago, IL
  • NPI 1205582095
  NPD (past)

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

{
    "created_epoch": "1359331200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1692403200000",
    "number": "1649518515",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3S101 ROCKWELL ST UNIT 247",
            "city": "WARRENVILLE",
            "state": "IL",
            "postal_code": "605552948",
            "telephone_number": "312-543-2133"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "24W788 75TH ST",
            "city": "NAPERVILLE",
            "state": "IL",
            "postal_code": "605651684",
            "telephone_number": "312-543-2133"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1802 W Berteau Ave Ste 205",
            "address_purpose": "LOCATION",
            "city": "Chicago",
            "state": "IL",
            "postal_code": "606136182",
            "country_code": "US",
            "telephone_number": "312-543-2133",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "MIND BODY CONNECTIONS PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-01-28",
        "last_updated": "2023-08-19",
        "certification_date": "2023-08-19",
        "status": "A",
        "authorized_official_last_name": "HURST",
        "authorized_official_first_name": "STACEY",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "312-543-2133",
        "authorized_official_credential": "LCPC"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Professional",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "221700000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Art Therapist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "225600000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dance Therapist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": "IL",
            "license": "180-003221",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Clinic/Center in Naperville, IL
• Providers in Naperville, IL by specialty
• Clinic/Center in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 19, 2023; 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.