Olive Branch Counseling PLLC

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

Legal business name

OLIVE BRANCH COUNSELING PLLC

Practice address

128 Ellsworth St
Crystal Lake, IL 60014-4421

Phone

(815) 307-4849

NPI assigned

Sep 13, 2021

Last updated

Sep 13, 2021By 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

Madysen Marie Ostrowski, LCPCNPI 1487069076

Title

Owner/Mental Health Therapist

Phone

(815) 307-4849

Specialties & licenses 1

Addresses

Other identifiers 1

Electronic endpoints 1

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.

• Madysen Marie Ostrowski, LCPC

  • Mental Health Counselor
  • McHenry, IL
  • NPI 1487069076
  NPD Authorized official
• Sandra Payne, LPC

  • Professional Counselor
  • Mount Juliet, TN
  • NPI 1770958944
  NPD (past)

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

{
    "created_epoch": "1631491200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1631491200000",
    "number": "1669142519",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "128 ELLSWORTH ST",
            "city": "CRYSTAL LAKE",
            "state": "IL",
            "postal_code": "600144421",
            "telephone_number": "815-307-4849"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "128 ELLSWORTH ST",
            "city": "CRYSTAL LAKE",
            "state": "IL",
            "postal_code": "600144421",
            "telephone_number": "815-307-4849"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "OLIVE BRANCH COUNSELING PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-09-13",
        "last_updated": "2021-09-13",
        "certification_date": "2021-09-13",
        "status": "A",
        "authorized_official_last_name": "OSTROWSKI",
        "authorized_official_first_name": "MADYSEN",
        "authorized_official_middle_name": "MARIE",
        "authorized_official_title_or_position": "OWNER/MENTAL HEALTH THERAPIST",
        "authorized_official_telephone_number": "815-307-4849",
        "authorized_official_credential": "LCPC"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LCPC/OWNER",
            "identifier": "180010920",
            "state": "IL"
        }
    ],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "www.olive-branch-counseling.com",
            "affiliation": "N",
            "endpointDescription": "website",
            "address_1": "128 Ellsworth St",
            "city": "Crystal Lake",
            "state": "IL",
            "country_code": "US",
            "postal_code": "600144421",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• John James O'Neill, O.D.
• Jennifer Lynn Oetgen, PHARMD
• Ofelia Pod, DMD, PC
• Makiko Ogino-McElligott, PA-C
• Daniel Okon
• Joan E. Olson, MS, OTR/L
• Nancy Diane Olson, MA, NCC, LCPC
• Stephanie L Olson
• Abiodun Emmanuel Oludaisi
• Afsheen Mumtaz Ommar, D.D.S.

• 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 Sep 13, 2021; 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.