Individual provider Active NPI

Jonathan Paul P. Barbosa

  • Professional Counselor
  • Crystal Lake, IL
National Provider Identifier
1801749684
Registry record updated Jul 16, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
178.032821 Issued in IL
Practice address
377 W Virginia St
Crystal Lake, IL 60014-5756
Phone
(815) 707-4806
NPI assigned
Feb 19, 2026
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 16, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Professional Counselor 101YP2500X 178.032821 IL Primary

Addresses

Primary practice location

377 W Virginia St
Crystal Lake, IL 60014-5756

Mailing address

377 W Virginia St
Crystal Lake, IL 60014-5756
Phone (815) 707-4806

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

NPI Registry JSON

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

{
    "created_epoch": "1771459200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1784160000000",
    "number": "1801749684",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "377 W VIRGINIA ST",
            "city": "CRYSTAL LAKE",
            "state": "IL",
            "postal_code": "600145756",
            "telephone_number": "815-707-4806"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "377 W VIRGINIA ST",
            "city": "CRYSTAL LAKE",
            "state": "IL",
            "postal_code": "600145756",
            "telephone_number": "815-707-4806"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BARBOSA",
        "first_name": "JONATHAN PAUL",
        "middle_name": "P.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2026-02-19",
        "last_updated": "2026-07-16",
        "certification_date": "2026-07-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "IL",
            "license": "178.032821",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Crystal Lake, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 16, 2026; 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.