Leap of Faith Wellness LLC

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

Legal business name

LEAP OF FAITH WELLNESS LLC

Practice address

3663 W Church Rd
Beecher, IL 60401-3501

Phone

(773) 598-4532

NPI assigned

May 30, 2019

Organization subpart

No

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

Authorized official

Name

Kristen Marie Scott, LCPC

Title

Founder, Executive Director

Phone

(773) 598-4532

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in IL

Enrollment records 1

Practitioners 4

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

• Robyn Marie Caravello, LPC

  • Professional Counselor
  • Oak Forest, IL
  • NPI 1326681388
  Medicare reassignment NPD
• Hope Danielle Barnes, LCSW

  • Clinical Social Worker
  • Springfield, MO
  • NPI 1619508397

  IL

  Medicare reassignment NPD
• Alison Boutcher-Cuthbertson, MA, LCPC

  • Mental Health Counselor
  • Beecher, IL
  • NPI 1093547036
  NPD (past)
• Maureen Fogarty, INTERN

  • Student in an Organized Health Care Education/Training Program
  • Beecher, IL
  • NPI 1245844455
  NPD (past)

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

{
    "created_epoch": "1559174400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1559174400000",
    "number": "1922666502",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3663 W CHURCH RD",
            "city": "BEECHER",
            "state": "IL",
            "postal_code": "604013501",
            "telephone_number": "773-598-4532"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3663 W CHURCH RD",
            "city": "BEECHER",
            "state": "IL",
            "postal_code": "604013501",
            "telephone_number": "773-598-4532"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LEAP OF FAITH WELLNESS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-05-30",
        "last_updated": "2019-05-30",
        "status": "A",
        "authorized_official_last_name": "SCOTT",
        "authorized_official_first_name": "KRISTEN",
        "authorized_official_middle_name": "MARIE",
        "authorized_official_title_or_position": "FOUNDER, EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "773-598-4532",
        "authorized_official_credential": "LCPC"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Professional",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• John R Deforest D.O. S.C.
• Crystal Johnson
• Joseph William Kenny, DDS
• Jackie Kotecki, DC
• Kristen Kozy
• LF Walls Corp (Walls Services Facilitation)
• Joyce Maclaren, PSY.D.
• Shane Malecha, PT, DPT, MS, CSCS
• Jamie Marting
• Colleen Mathews, PTA

• Professional Counselor in Beecher, IL
• Providers in Beecher, IL by specialty
• Professional Counselor in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 30, 2019; 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.