NPIMap

Organization Active NPI

Center for Christian Life Enrichment

  • Mental Health Counselor
  • Northbrook, IL
National Provider Identifier
1891186383
Registry record updated Nov 24, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
180.009135 Issued in IL
Legal business name
CENTER FOR CHRISTIAN LIFE ENRICHMENT
Practice address
3100 Dundee Rd Ste 102
Northbrook, IL 60062-2462
Phone
(847) 272-3684
Fax
(847) 272-7934
NPI assigned
Feb 5, 2015
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 24, 2015

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

Authorized official

Name
Steve Nicoloff
Title
Office Manager
Phone
(847) 272-3684

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health CounselorGroup: 193200000X MULTI-SPECIALTY GROUP 101YM0800X 180.009135 IL Primary

Addresses

Primary practice location

3100 Dundee Rd Ste 102
Northbrook, IL 60062-2462

Mailing address

3100 Dundee Rd Ste 102
Northbrook, IL 60062-2462
Phone (847) 272-3684

National Provider Directory

National Provider Directory
Tax ID family
Center for Christian Life Enrichment2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Locations

3100 Dundee Rd
Ste 102
Northbrook, IL 60062
Phone (847) 272-3684

Practitioners & affiliated clinicians

Practitioners 4

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": "1423094400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1448323200000",
    "number": "1891186383",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3100 DUNDEE RD STE 102",
            "city": "NORTHBROOK",
            "state": "IL",
            "postal_code": "600622462",
            "telephone_number": "847-272-3684",
            "fax_number": "847-272-7934"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3100 DUNDEE RD STE 102",
            "city": "NORTHBROOK",
            "state": "IL",
            "postal_code": "600622462",
            "telephone_number": "847-272-3684",
            "fax_number": "847-272-7934"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CENTER FOR CHRISTIAN LIFE ENRICHMENT",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-02-05",
        "last_updated": "2015-11-24",
        "status": "A",
        "authorized_official_last_name": "NICOLOFF",
        "authorized_official_first_name": "STEVE",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "847-272-3684"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Mental Health",
            "state": "IL",
            "license": "180.009135",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Northbrook, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 24, 2015; 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.