Organization Active NPI

Green Leaf Counseling PLLC

  • Professional Counselor
  • Schaumburg, IL
National Provider Identifier
1811635469
Registry record updated Nov 12, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
Legal business name
GREEN LEAF COUNSELING PLLC
Practice address
715 E Golf Rd Ste 200A5B
Schaumburg, IL 60173-4595
Phone
(847) 857-7811
NPI assigned
May 24, 2022
Last updated
Nov 12, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 12, 2024

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

Authorized official

Name
Patricia Bahnick, LCPCNPI 1790339083
Title
Owner
Phone
(847) 857-7811

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
Professional Counselor 101YP2500X NU Primary

Addresses

Primary practice location

715 E Golf Rd Ste 200A5B
Schaumburg, IL 60173-4595

Mailing address

715 E Golf Rd Ste 200A5B
Schaumburg, IL 60173-4595
Phone (847) 857-7811

Other practice location 1

7210 E State St Ste 102
Rockford, IL 61108-2636
Phone (847) 857-7811

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20240410001694 IL Part B Supplier - Clinic/Group Practice 9739527730 Receives reassigned benefits from 1 practitioner
Practice locations: Schaumburg, IL

National Provider Directory

National Provider Directory

Locations

715 E Golf Rd
Ste 200A5B
Schaumburg, IL 60173
Phone (847) 857-7811

Practitioners & affiliated clinicians

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.

NPI Registry JSON

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

{
    "created_epoch": "1653350400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1731369600000",
    "number": "1811635469",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "715 E GOLF RD STE 200A5B",
            "city": "SCHAUMBURG",
            "state": "IL",
            "postal_code": "601734595",
            "telephone_number": "847-857-7811"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "715 E GOLF RD STE 200A5B",
            "city": "SCHAUMBURG",
            "state": "IL",
            "postal_code": "601734595",
            "telephone_number": "847-857-7811"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "7210 E State St Ste 102",
            "address_purpose": "LOCATION",
            "city": "Rockford",
            "state": "IL",
            "postal_code": "611082636",
            "country_code": "US",
            "telephone_number": "847-857-7811",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "GREEN LEAF COUNSELING PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-05-24",
        "last_updated": "2024-11-12",
        "certification_date": "2024-11-12",
        "status": "A",
        "authorized_official_last_name": "BAHNICK",
        "authorized_official_first_name": "PATRICIA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "847-857-7811",
        "authorized_official_credential": "LCPC"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Schaumburg, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 12, 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.