Organization Active NPI

Lifecare Counseling, LTD

  • Professional Counselor
  • Glen Ellyn, IL
National Provider Identifier
1710206644
Registry record updated May 17, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
180006762 Issued in IL
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

Updated by the provider on May 17, 2010

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)CodeLicenseStatePrimary
Professional CounselorGroup: 193200000X MULTI-SPECIALTY GROUP 101YP2500X 180006762 IL Primary
Pharmacotherapy PharmacistGroup: 193200000X MULTI-SPECIALTY GROUP 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 Directory

Locations

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.

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.

Verify at the official NPI Registry.