Kimberly Greyson-Bost, LCPC
Individual provider Active NPI Professional Counselor · Roscoe, IL
NPI 1801348115 · NPPES record last updated Jul 30, 2024
Key facts
- NPI
- 1801348115
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Professional Counselor 101YP2500X
- License
- 180.012442 (IL)
- Practice address
- 11361 Main St
Roscoe, IL 61073-8851 - Phone
- (815) 270-0168
- Fax
- (855) 564-1779
- NPI assigned
- Nov 3, 2016
- Sex
- Female
- Sole proprietor
- Yes
Organizations & group practices 1
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 180.012442 | IL | MD | Professional Counselor |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Clearings Counseling Center Inc | Professional | Current |
Accepting new patients |
Locations
11742 Main St
Ste 2
Roscoe, IL 61073
Phone (815) 270-0168
11361 Main St
Roscoe, IL 61073
Phone (779) 212-4721
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Professional Counselor | 101YP2500X | 180.012442 | IL | Yes |
Addresses
Primary practice location
11361 Main St
Roscoe, IL 61073-8851
Mailing address
11361 Main St
Roscoe, IL 61073-8851
Phone (815) 270-0168
Electronic endpoints
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Other URL | SimplePractice |
Other providers in Roscoe, IL
- James B Garrison
- Nicholas A Garza
- Paul Gerard Graham
- Gregory S. Granzeier
- Kali Gray
- Ryan John Robert Griffin
- Ramona M Gulley
- Xiaoxiao Guo
- Jeffrey David Gurtizen
- Emily Kathleen Hamaker
All providers in Roscoe, IL · Professional Counselor in Illinois
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 30, 2024. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.