NPIMap

Organization Active NPI

Long Grove Center for Emotional Health LLC

  • Mental Health Counselor
  • Long Grove, IL
National Provider Identifier
1790220820
Registry record updated Dec 28, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
071005290 Issued in IL
Legal business name
LONG GROVE CENTER FOR EMOTIONAL HEALTH LLC
Practice address
4180 RFD
Suite 10
Long Grove, IL 60047
Phone
(847) 830-8600
Fax
(847) 821-1218
NPI assigned
Dec 28, 2016
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 28, 2016

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

Authorized official

Name
Dr. Michelle Ann Navarro, PSY.D.NPI 1043370778
Title
Licensed Clinical Psychologist
Phone
(847) 830-8600

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health CounselorGroup: 193200000X MULTI-SPECIALTY GROUP 101YM0800X 071005290 IL Primary

Addresses

Primary practice location

4180 RFD
Suite 10
Long Grove, IL 60047

Mailing address

4180 RFD
Suite 10
Long Grove, IL 60047
Phone (847) 830-8600

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20181005002520 IL Part B Supplier - Clinic/Group Practice 0042562886 Receives reassigned benefits from 6 practitioners
Practice locations: Long Grove, IL

National Provider Directory

National Provider Directory

Locations

4180 Rfd
Ste 10
Long Grove, IL 60047
Phone (847) 830-8600

Practitioners & affiliated clinicians

Practitioners 8

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": "1482883200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1482883200000",
    "number": "1790220820",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4180 RFD",
            "address_2": "SUITE 10",
            "city": "LONG GROVE",
            "state": "IL",
            "postal_code": "60047",
            "telephone_number": "847-830-8600",
            "fax_number": "847-821-1218"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4180 RFD",
            "address_2": "SUITE 10",
            "city": "LONG GROVE",
            "state": "IL",
            "postal_code": "60047",
            "telephone_number": "847-830-8600",
            "fax_number": "847-821-1218"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LONG GROVE CENTER FOR EMOTIONAL HEALTH LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-12-28",
        "last_updated": "2016-12-28",
        "status": "A",
        "authorized_official_last_name": "NAVARRO",
        "authorized_official_first_name": "MICHELLE",
        "authorized_official_middle_name": "ANN",
        "authorized_official_title_or_position": "LICENSED CLINICAL PSYCHOLOGIST",
        "authorized_official_telephone_number": "847-830-8600",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PSY.D."
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Mental Health",
            "state": "IL",
            "license": "071005290",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Long Grove, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 28, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.