NPIMap

Organization Active NPI

Wholistically Therapeutic LLC

  • Professional Counselor
  • Orland Park, IL
National Provider Identifier
1922628015
Registry record updated May 6, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
Legal business name
WHOLISTICALLY THERAPEUTIC LLC
Practice address
15255 S 94TH Ave Ste 500
Orland Park, IL 60462-3895
Phone
(708) 834-7544
Fax
(708) 834-7541
NPI assigned
Apr 20, 2020
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 6, 2025

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

Authorized official

Name
Ms. Dominique Clemons, LCPCNPI 1396379483
Title
Owner/Therapist
Phone
(708) 834-7544

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 CounselorGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 101YP2500X Primary

Addresses

Primary practice location

15255 S 94TH Ave Ste 500
Orland Park, IL 60462-3895

Mailing address

15255 S 94TH Ave Ste 500
Orland Park, IL 60462-3895
Phone (708) 834-7544

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 3

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": "1587340800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1746489600000",
    "number": "1922628015",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15255 S 94TH AVE STE 500",
            "city": "ORLAND PARK",
            "state": "IL",
            "postal_code": "604623895",
            "telephone_number": "708-834-7544",
            "fax_number": "708-834-7541"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15255 S 94TH AVE STE 500",
            "city": "ORLAND PARK",
            "state": "IL",
            "postal_code": "604623895",
            "telephone_number": "708-834-7544",
            "fax_number": "708-834-7541"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WHOLISTICALLY THERAPEUTIC LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-04-20",
        "last_updated": "2025-05-06",
        "certification_date": "2025-05-06",
        "status": "A",
        "authorized_official_last_name": "CLEMONS",
        "authorized_official_first_name": "DOMINIQUE",
        "authorized_official_title_or_position": "OWNER/THERAPIST",
        "authorized_official_telephone_number": "708-834-7544",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "LCPC"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Counselor, Professional",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Orland Park, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 6, 2025; 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.