Constance Renae White, MA

Primary specialty

CounselorTaxonomy code 101Y00000X

Practice address

500 Coventry LN Ste 130
Crystal Lake, IL 60014-7578

Phone

(815) 889-0582

Fax

(815) 205-4083

NPI assigned

Jun 24, 2013

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other names 1

• Constance Renae Burden Former name

Medicare fee-for-service enrollment

Enrolled in IL

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Mental Health Counselor

Education

Other, 2014

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Geek Therapy Guild PLLCGroup PAC ID 6608216528, 3 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Master of Arts

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Geek Therapy Guild PLLC

  • Clinical Social Worker
  • Crystal Lake, IL
  • NPI 1710749353
  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1372032000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1733270400000",
    "number": "1649619537",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2707 3 OAKS RD UNIT 932",
            "city": "CARY",
            "state": "IL",
            "postal_code": "600133525",
            "telephone_number": "224-432-6419"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "500 COVENTRY LN STE 130",
            "city": "CRYSTAL LAKE",
            "state": "IL",
            "postal_code": "600147578",
            "telephone_number": "815-889-0582",
            "fax_number": "815-205-4083"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WHITE",
        "first_name": "CONSTANCE",
        "middle_name": "RENAE",
        "credential": "MA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2013-06-24",
        "last_updated": "2024-12-04",
        "certification_date": "2024-12-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": "IL",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "CONSTANCE",
            "last_name": "BURDEN",
            "middle_name": "RENAE",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Wellness Institute of Illinois, LTD
• Wellness Institute of Illinois, LTD.
• Breanne Nichole Welty
• Todd F. Wenzon, D.D.S.
• Thomas D Weyburn Jr., D.O.
• Amy Whitenack, MS IN CLIN. COUNSELI
• Laurie L Whitlock
• Laura B Whyte
• John Widger
• Brenda Wierzbicki

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 4, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.