Active NPI
Lifecare Counseling, LTD
- Professional Counselor
- Glen Ellyn, IL
National Provider Identifier
1710206644
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Professional Counselor
- License
- 180006762
- Legal business name
- LIFECARE COUNSELING, LTD
- Practice address
- 460 N Main St
Ste 202
Glen Ellyn, IL 60137-5176 - Phone
- (630) 984-4896
- Fax
- (630) 545-3630
- NPI assigned
- May 17, 2010
- 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
- Mrs. Holly Lynne Shrake, M.S., L.C.P.C., NCC
- Title
- Clinical Director
- Phone
- (630) 984-4896
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Professional Counselor | 101YP2500X | 180006762 | IL | Primary |
| Pharmacotherapy Pharmacist | 1835P1200X | 051.034790 | IL |
Addresses
Primary practice location
460 N Main St
Ste 202
Glen Ellyn, IL 60137-5176
Mailing address
460 N Main St
Ste 202
Glen Ellyn, IL 60137-5176
Phone (630) 984-4896
National Provider Directory
National Provider DirectoryLocations
460 N Main St
Ste 202
Glen Ellyn, IL 60137
Phone (630) 984-4896
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
- Naperville, IL
- NPI 1689012254
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1274054400000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1274054400000",
"number": "1710206644",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "460 N MAIN ST",
"address_2": "STE 202",
"city": "GLEN ELLYN",
"state": "IL",
"postal_code": "601375176",
"telephone_number": "630-984-4896",
"fax_number": "630-545-3630"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "460 N MAIN ST",
"address_2": "STE 202",
"city": "GLEN ELLYN",
"state": "IL",
"postal_code": "601375176",
"telephone_number": "630-984-4896",
"fax_number": "630-545-3630"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "LIFECARE COUNSELING, LTD",
"organizational_subpart": "NO",
"enumeration_date": "2010-05-17",
"last_updated": "2010-05-17",
"status": "A",
"authorized_official_last_name": "SHRAKE",
"authorized_official_first_name": "HOLLY",
"authorized_official_middle_name": "LYNNE",
"authorized_official_title_or_position": "CLINICAL DIRECTOR",
"authorized_official_telephone_number": "630-984-4896",
"authorized_official_name_prefix": "Mrs.",
"authorized_official_credential": "M.S., L.C.P.C., NCC"
},
"taxonomies": [
{
"code": "101YP2500X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Counselor, Professional",
"state": "IL",
"license": "180006762",
"primary": true
},
{
"code": "1835P1200X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Pharmacist, Pharmacotherapy",
"state": "IL",
"license": "051.034790",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Glen Ellyn, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 17, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.