Organization Active NPI

Brookside Counseling and Wellness, PLLC

  • Clinical Social Worker
  • Dekalb, IL
National Provider Identifier
1801771969
Registry record updated Sep 3, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
Legal business name
BROOKSIDE COUNSELING AND WELLNESS, PLLC
Practice address
2463 Pleasant St
Dekalb, IL 60115-8463
Phone
(847) 262-3722
NPI assigned
Aug 7, 2025
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 3, 2025

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

Authorized official

Name
Kerri Phalp, LCSWNPI 1639498660
Title
Owner
Phone
(847) 262-3722

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
Clinical Social WorkerGroup: 193400000X SINGLE SPECIALTY GROUP 1041C0700X Primary

Addresses

Primary practice location

2463 Pleasant St
Dekalb, IL 60115-8463

Mailing address

2463 Pleasant St
Dekalb, IL 60115-8463
Phone (847) 262-3722

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

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": "1754524800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1756857600000",
    "number": "1801771969",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2463 PLEASANT ST",
            "city": "DEKALB",
            "state": "IL",
            "postal_code": "601158463",
            "telephone_number": "847-262-3722",
            "fax_number": "630-953-5540"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2463 PLEASANT ST",
            "city": "DEKALB",
            "state": "IL",
            "postal_code": "601158463",
            "telephone_number": "847-262-3722"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BROOKSIDE COUNSELING AND WELLNESS, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-08-07",
        "last_updated": "2025-09-03",
        "certification_date": "2025-09-03",
        "status": "A",
        "authorized_official_last_name": "PHALP",
        "authorized_official_first_name": "KERRI",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "847-262-3722",
        "authorized_official_credential": "LCSW"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Dekalb, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 3, 2025; 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.