Organization Active NPI

Mindspring Emdr, PLLC

  • Professional Counselor
  • Park Ridge, IL
National Provider Identifier
1699548198
Registry record updated Nov 6, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
Legal business name
MINDSPRING EMDR, PLLC
Practice address
11 N Northwest Hwy Ste 126
Park Ridge, IL 60068-3444
Phone
(847) 780-6575
NPI assigned
Nov 6, 2023
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 6, 2023

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

Authorized official

Name
Tonya S Nowlin, MA, LCPCNPI 1154717627
Title
Clinical Therapist
Phone
(847) 780-6575

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
Professional CounselorGroup: 193400000X SINGLE SPECIALTY GROUP 101YP2500X Primary

Addresses

Primary practice location

11 N Northwest Hwy Ste 126
Park Ridge, IL 60068-3444

Mailing address

11 N Northwest Hwy Ste 126
Park Ridge, IL 60068-3444
Phone (847) 780-6575

National Provider Directory

National Provider Directory

Locations

11 N Northwest Hwy
Ste 126
Park Ridge, IL 60068
Phone (636) 614-6647

Practitioners & affiliated clinicians

Practitioners 1

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

NPI Registry JSON

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

{
    "created_epoch": "1699228800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1699228800000",
    "number": "1699548198",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11 N NORTHWEST HWY STE 126",
            "city": "PARK RIDGE",
            "state": "IL",
            "postal_code": "600683444",
            "telephone_number": "847-780-6575"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11 N NORTHWEST HWY STE 126",
            "city": "PARK RIDGE",
            "state": "IL",
            "postal_code": "600683444",
            "telephone_number": "847-780-6575"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MINDSPRING EMDR, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-11-06",
        "last_updated": "2023-11-06",
        "certification_date": "2023-11-06",
        "status": "A",
        "authorized_official_last_name": "NOWLIN",
        "authorized_official_first_name": "TONYA",
        "authorized_official_middle_name": "S",
        "authorized_official_title_or_position": "CLINICAL THERAPIST",
        "authorized_official_telephone_number": "847-780-6575",
        "authorized_official_credential": "MA, LCPC"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Counselor, Professional",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Park Ridge, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 6, 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.