NPIMap

Organization Active NPI

Providentia Counseling Group LLC

  • Mental Health Counselor
  • Naperville, IL
National Provider Identifier
1851912869
Registry record updated Apr 30, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
Legal business name
PROVIDENTIA COUNSELING GROUP LLC
Practice address
680 Milton Dr
Naperville, IL 60563-3342
Phone
(630) 888-6625
NPI assigned
Apr 30, 2020
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 30, 2020

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

Authorized official

Name
Zachary Simms, M.S.NPI 1689195448
Title
LCPC
Phone
(630) 888-6625

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
Mental Health CounselorGroup: 193400000X SINGLE SPECIALTY GROUP 101YM0800X Primary

Addresses

Primary practice location

680 Milton Dr
Naperville, IL 60563-3342

Mailing address

680 Milton Dr
Naperville, IL 60563-3342
Phone (630) 888-6625

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": "1588204800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1588204800000",
    "number": "1851912869",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "680 MILTON DR",
            "city": "NAPERVILLE",
            "state": "IL",
            "postal_code": "605633342",
            "telephone_number": "630-888-6625"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "680 MILTON DR",
            "city": "NAPERVILLE",
            "state": "IL",
            "postal_code": "605633342",
            "telephone_number": "630-888-6625"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PROVIDENTIA COUNSELING GROUP LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-04-30",
        "last_updated": "2020-04-30",
        "certification_date": "2020-04-30",
        "status": "A",
        "authorized_official_last_name": "SIMMS",
        "authorized_official_first_name": "ZACHARY",
        "authorized_official_title_or_position": "LCPC",
        "authorized_official_telephone_number": "630-888-6625",
        "authorized_official_credential": "M.S."
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Naperville, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 30, 2020; 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.