Kind Harbor Counseling, PLLC

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

Legal business name

KIND HARBOR COUNSELING, PLLC

Practice address

701 Devonshire Dr Ste D-2B
Champaign, IL 61820-7337

Phone

(312) 854-9661

NPI assigned

May 18, 2022

Organization subpart

No

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

Authorized official

Name

Rose St Clair, LCSWNPI 1043957392

Title

Owner

Phone

(312) 854-9661

Specialties & licenses 1

Addresses

Locations

Practitioners 1

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

• Rose St Clair, LCSW

  • Clinical Social Worker
  • Champaign, IL
  • NPI 1043957392
  NPD Authorized official

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

{
    "created_epoch": "1652832000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1663200000000",
    "number": "1740927003",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "701 DEVONSHIRE DR STE D-2B",
            "city": "CHAMPAIGN",
            "state": "IL",
            "postal_code": "618207337",
            "telephone_number": "312-854-9661"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "701 DEVONSHIRE DR STE D-2B",
            "city": "CHAMPAIGN",
            "state": "IL",
            "postal_code": "618207337",
            "telephone_number": "312-854-9661"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KIND HARBOR COUNSELING, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-05-18",
        "last_updated": "2022-09-15",
        "certification_date": "2022-09-15",
        "status": "A",
        "authorized_official_last_name": "ST CLAIR",
        "authorized_official_first_name": "ROSE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "312-854-9661",
        "authorized_official_credential": "LCSW"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Dale Kim
• Jane C Kim, MD
• John H Kim, NP
• Joseph Taeyoo Kim, D.C.
• Ronnie Kim, NP
• Lisa Kinderman, PSY.D.
• Laurel King
• Lorene King, RBT
• Matthew King, PHD
• Olivia E King, BS

• Clinical Social Worker in Champaign, IL
• Providers in Champaign, IL by specialty
• Clinical Social Worker in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 15, 2022; 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.