NPIMap

Organization Active NPI

Modus Operandi LLC

Doing business as Blackberry Counseling Center

  • Mental Health Counselor
  • Elburn, IL
National Provider Identifier
1821684986
Registry record updated Dec 14, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
Legal business name
MODUS OPERANDI LLC
Doing business as
Blackberry Counseling Center
Practice address
21 S Main St Unit a
Elburn, IL 60119-9194
Phone
(815) 761-4923
NPI assigned
Dec 14, 2020
Last updated
Dec 14, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 14, 2020

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

Authorized official

Name
Mrs. Brittany Male, LCSW
Title
Owner
Phone
(815) 761-4923

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health CounselorGroup: 193200000X MULTI-SPECIALTY GROUP 101YM0800X Primary

Addresses

Primary practice location

21 S Main St Unit a
Elburn, IL 60119-9194

Mailing address

43W195 Whirlaway CT
Elburn, IL 60119-9554
Phone (815) 761-4923

Other practice location 1

43W195 Whirlaway Ct
Elburn, IL 60119-9554
Phone (815) 761-4923

Other names 1

  • Blackberry Counseling Center Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20221206002173 IL Part B Supplier - Clinic/Group Practice 2062744253 Receives reassigned benefits from 3 practitioners
Practice locations: Elburn, IL

National Provider Directory

National Provider Directory

Locations

21 S Main St
Unit A
Elburn, IL 60119
Phone (217) 471-4229

Practitioners & affiliated clinicians

Practitioners 5

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": "1607904000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1607904000000",
    "number": "1821684986",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "43W195 WHIRLAWAY CT",
            "city": "ELBURN",
            "state": "IL",
            "postal_code": "601199554",
            "telephone_number": "815-761-4923"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "21 S MAIN ST UNIT A",
            "city": "ELBURN",
            "state": "IL",
            "postal_code": "601199194",
            "telephone_number": "815-761-4923"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "43W195 Whirlaway Ct",
            "address_purpose": "LOCATION",
            "city": "Elburn",
            "state": "IL",
            "postal_code": "601199554",
            "country_code": "US",
            "telephone_number": "815-761-4923",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "MODUS OPERANDI LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-12-14",
        "last_updated": "2020-12-14",
        "certification_date": "2020-12-11",
        "status": "A",
        "authorized_official_last_name": "MALE",
        "authorized_official_first_name": "BRITTANY",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "815-761-4923",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "LCSW"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Blackberry Counseling Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Elburn, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 14, 2020; 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.