NPIMap

Organization Active NPI

Mosaic Counseling and Wellness LLC

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Oak Park, IL
National Provider Identifier
1851065502
Registry record updated Jun 23, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health Clinic/Center (Including Community Mental Health Center)Taxonomy code 261QM0801X
Legal business name
MOSAIC COUNSELING AND WELLNESS LLC
Practice address
1010 Lake St
Oak Park, IL 60301-1147
Phone
(708) 628-8000
NPI assigned
Aug 5, 2021
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 23, 2023

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

Authorized official

Name
Carey Carlock, MA
Title
Manager
Phone
(708) 628-8000

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Clinic/Center (Including Community Mental Health Center) 261QM0801X Primary
Multi-Specialty Clinic/Center 261QM1300X

Addresses

Primary practice location

1010 Lake St
Oak Park, IL 60301-1147

Mailing address

386 N. York Rd
Suite 204
Elmhurst, IL 60126-2365
Phone (708) 628-8000

Other practice location 1

386 N. York Road
Suite 204
Elmhurst, IL 60126
Phone (708) 628-8000

Other names 1

  • Mosaic Counseling and Wellness Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20220512001904 IL Part B Supplier - Clinic/Group Practice 1355728353 Receives reassigned benefits from 51 practitioners
Practice locations: Elmhurst, IL; Hinsdale, IL; Oak Park, IL; Orland Park, IL

National Provider Directory

National Provider Directory

Locations

119 E Ogden Ave
Ste 130
Hinsdale, IL 60521
Phone (708) 628-8000

Practitioners & affiliated clinicians

Practitioners 83

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

View all 83

NPI Registry JSON

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

{
    "created_epoch": "1628121600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1687478400000",
    "number": "1851065502",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "386 N. YORK RD",
            "address_2": "SUITE 204",
            "city": "ELMHURST",
            "state": "IL",
            "postal_code": "601262365",
            "telephone_number": "708-628-8000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1010 LAKE ST",
            "city": "OAK PARK",
            "state": "IL",
            "postal_code": "603011147",
            "telephone_number": "708-628-8000"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "386 N. York Road",
            "address_2": "Suite 204",
            "address_purpose": "LOCATION",
            "city": "Elmhurst",
            "state": "IL",
            "postal_code": "60126",
            "country_code": "US",
            "telephone_number": "708-628-8000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "MOSAIC COUNSELING AND WELLNESS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-08-05",
        "last_updated": "2023-06-23",
        "certification_date": "2022-02-17",
        "status": "A",
        "authorized_official_last_name": "CARLOCK",
        "authorized_official_first_name": "CAREY",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "708-628-8000",
        "authorized_official_credential": "MA"
    },
    "taxonomies": [
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "261QM1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Multi-Specialty",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Mosaic Counseling and Wellness",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Mosaic Counseling and Wellness",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Oak Park, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 23, 2023; 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.