Active NPI
Mindspring Emdr, PLLC
- Professional Counselor
- Park Ridge, IL
National Provider Identifier
1699548198
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Professional Counselor
- 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
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Tonya S Nowlin, MA, LCPC
- 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) | Code | License | State | Primary |
|---|---|---|---|---|
| Professional Counselor | 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 DirectoryLocations
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.
-
- Professional Counselor
- Park Ridge, IL
- NPI 1154717627
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.