Organization Active NPI

Lasting Serenity Counseling Services LLC

  • Mental Health Counselor
  • Washington, IL
National Provider Identifier
1770052110
Registry record updated Nov 14, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
Legal business name
LASTING SERENITY COUNSELING SERVICES LLC
Practice address
24363 Spring Creek Rd Ste H
Washington, IL 61571-9654
Phone
(815) 310-0722
Fax
(309) 276-0308
NPI assigned
Nov 14, 2018
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 14, 2018

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

Authorized official

Name
Nichole Lee Bosserman, LCPC
Title
Owner
Phone
(815) 310-0722

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health CounselorGroup: 193400000X SINGLE SPECIALTY GROUP 101YM0800X Primary

Addresses

Primary practice location

24363 Spring Creek Rd Ste H
Washington, IL 61571-9654

Mailing address

24363 Spring Creek Rd Ste H
Washington, IL 61571-9654
Phone (815) 310-0722

National Provider Directory

National Provider Directory

Locations

24363 Spring Creek Rd
Ste H
Washington, IL 61571
Phone (309) 204-9881

NPI Registry JSON

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

{
    "created_epoch": "1542153600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1542153600000",
    "number": "1770052110",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "24363 SPRING CREEK RD STE H",
            "city": "WASHINGTON",
            "state": "IL",
            "postal_code": "615719654",
            "telephone_number": "815-310-0722",
            "fax_number": "309-276-0308"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "24363 SPRING CREEK RD STE H",
            "city": "WASHINGTON",
            "state": "IL",
            "postal_code": "615719654",
            "telephone_number": "815-310-0722",
            "fax_number": "309-276-0308"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LASTING SERENITY COUNSELING SERVICES LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-11-14",
        "last_updated": "2018-11-14",
        "status": "A",
        "authorized_official_last_name": "BOSSERMAN",
        "authorized_official_first_name": "NICHOLE",
        "authorized_official_middle_name": "LEE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "815-310-0722",
        "authorized_official_credential": "LCPC"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Washington, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 14, 2018; 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.