Counseling Center of Grayslake

Primary specialty

Community/Behavioral Health AgencyTaxonomy code 251S00000X

License

149.014706 Issued in IL

Legal business name

COUNSELING CENTER OF GRAYSLAKE

Practice address

142 Hawley St Ste 5
Grayslake, IL 60030-3653

Phone

(847) 962-9549

NPI assigned

Jun 19, 2016

Last updated

Jun 19, 2016By 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

Julie Pettinato, LCSWNPI 1447531777

Title

Owner

Phone

(847) 962-9549

Specialties & licenses 1

Addresses

Other identifiers 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.

• Julie A Pettinato, LCSW

  • Clinical Social Worker
  • Waukegan, IL
  • NPI 1447531777
  NPD (past) Authorized official
• Charles E. Hutchcraft II, MSW

  • Mental Health Counselor
  • Waukegan, IL
  • NPI 1033483490
  NPD (past)

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

{
    "created_epoch": "1466294400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1466294400000",
    "number": "1730539966",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "34068 N WHITE OAK LN",
            "city": "GURNEE",
            "state": "IL",
            "postal_code": "600314446"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "142 HAWLEY ST STE 5",
            "city": "GRAYSLAKE",
            "state": "IL",
            "postal_code": "600303653",
            "telephone_number": "847-962-9549"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COUNSELING CENTER OF GRAYSLAKE",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-06-19",
        "last_updated": "2016-06-19",
        "status": "A",
        "authorized_official_last_name": "PETTINATO",
        "authorized_official_first_name": "JULIE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "847-962-9549",
        "authorized_official_credential": "LCSW"
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": "IL",
            "license": "149.014706",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PTAN",
            "identifier": "F300232686",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Connected Kids Pediatric Therapy, PC
• Anabella Cook
• Kyle R Cook, LSW, MSW
• Jessica Aubyn Cooksey, MD
• Andreea Maria Costea, M.D.
• Counseling Center of Grayslake LTD.
• Robert J Covek, DDS
• Carol Paxton Cox, PSY.D.
• Create Anew Wellness PLLC
• Cultivate Nutrition

• Community/Behavioral Health Agency in Grayslake, IL
• Providers in Grayslake, IL by specialty
• Community/Behavioral Health Agency in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 19, 2016; 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.