Inner Equinox Counseling Center LLC

Primary specialty

Adult Mental Health Clinic/CenterTaxonomy code 261QM0850X

Legal business name

INNER EQUINOX COUNSELING CENTER LLC

Practice address

8600 US Highway 14 Ste 220a
Crystal Lake, IL 60012-2711

Phone

(224) 338-6038

NPI assigned

Apr 27, 2021

Last updated

Dec 13, 2024By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Michelle Ann KRC Gerlach, LCSWNPI 1730647090

Title

Clinical Therapist

Phone

(224) 338-6038

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in IL

Enrollment records 1

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Michelle Ann KRC Gerlach, LCSW, MA

  • Clinical Social Worker
  • Crystal Lake, IL
  • NPI 1730647090
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1619481600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1734048000000",
    "number": "1811579030",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "215 FENIMORE RD",
            "city": "CRYSTAL LAKE",
            "state": "IL",
            "postal_code": "600147377",
            "telephone_number": "224-338-6038"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8600 US HIGHWAY 14 STE 220A",
            "city": "CRYSTAL LAKE",
            "state": "IL",
            "postal_code": "600122711",
            "telephone_number": "224-338-6038"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "INNER EQUINOX COUNSELING CENTER LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-04-27",
        "last_updated": "2024-12-13",
        "certification_date": "2024-12-13",
        "status": "A",
        "authorized_official_last_name": "GERLACH",
        "authorized_official_first_name": "MICHELLE",
        "authorized_official_middle_name": "ANN KRC",
        "authorized_official_title_or_position": "CLINICAL THERAPIST",
        "authorized_official_telephone_number": "224-338-6038",
        "authorized_official_credential": "LCSW"
    },
    "taxonomies": [
        {
            "code": "261QM0850X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adult Mental Health",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "261QM0855X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adolescent and Children Mental Health",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "F400646798",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Alexandra Marie Isrow, MT-BC
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• Adult Mental Health Clinic/Center in Crystal Lake, IL
• Providers in Crystal Lake, IL by specialty
• Adult Mental Health Clinic/Center in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 13, 2024; 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.