Untangle Counseling PLLC

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

Legal business name

UNTANGLE COUNSELING PLLC

Practice address

152 Elgin Ave Apt 3
Forest Park, IL 60130-1300

Phone

(224) 639-7776

NPI assigned

Feb 8, 2021

Organization subpart

No

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

Authorized official

Name

Samantha K Agins, LCPCNPI 1275030199

Title

Manager

Phone

(224) 639-7776

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.

• Samantha Kelsey Agins, M.A., LCPC

  • Mental Health Counselor
  • Forest Park, IL
  • NPI 1275030199
  NPD Authorized official

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

{
    "created_epoch": "1612742400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1612742400000",
    "number": "1780276154",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "417 DES PLAINES AVE UNIT 641",
            "city": "FOREST PARK",
            "state": "IL",
            "postal_code": "601304433",
            "telephone_number": "224-639-7776"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "152 ELGIN AVE APT 3",
            "city": "FOREST PARK",
            "state": "IL",
            "postal_code": "601301300",
            "telephone_number": "224-639-7776"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "UNTANGLE COUNSELING PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-02-08",
        "last_updated": "2021-02-08",
        "certification_date": "2021-02-08",
        "status": "A",
        "authorized_official_last_name": "AGINS",
        "authorized_official_first_name": "SAMANTHA",
        "authorized_official_middle_name": "K",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "224-639-7776",
        "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": []
}

• Ciara Valise Thomas, LCSW
• John Esteban Towers
• Chloe Tully, LCPC
• Jerry Udelson, DDS
• Kara Unatin
• Heather Rene Urban, MSOT, OTR/L
• Aviana Lys Valdez
• Stephanie Lizbeth Valdez
• Kenneth-Albert Fababaer Valenzuela, PT
• Amy Van Santen, P.T.

• Mental Health Counselor in Forest Park, IL
• Providers in Forest Park, IL by specialty
• Mental Health Counselor in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 8, 2021; 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.