Marvin Michael Bornschlegl, LCPC

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

180.006907 Issued in IL

Practice address

1460 Renaissance Dr
Suite 211
Park Ridge, IL 60068-1331

Phone

(847) 391-4180

Fax

(847) 391-4188

NPI assigned

Feb 14, 2009

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• New Leaf Counseling LLC

  • Community/Behavioral Health Agency
  • Park Ridge, IL
  • NPI 1023257045
  NPD (past) Authorized official

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

{
    "created_epoch": "1234569600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1234569600000",
    "number": "1932348950",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1460 RENAISSANCE DR",
            "address_2": "SUITE 211",
            "city": "PARK RIDGE",
            "state": "IL",
            "postal_code": "600681331",
            "telephone_number": "847-391-4180",
            "fax_number": "847-391-4188"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1460 RENAISSANCE DR",
            "address_2": "SUITE 211",
            "city": "PARK RIDGE",
            "state": "IL",
            "postal_code": "600681331",
            "telephone_number": "847-391-4180",
            "fax_number": "847-391-4188"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BORNSCHLEGL",
        "first_name": "MARVIN",
        "middle_name": "MICHAEL",
        "credential": "LCPC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2009-02-14",
        "last_updated": "2009-02-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "IL",
            "license": "180.006907",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Thomas Borders
• Josephine Difranco Bordignon, R.N., D.D.S.
• Sarah Elizabeth Borer, AU.D.
• Bryano Borges
• Jerry Mark Bornhoff, ATC, LAT, CSCS
• Alissa Danielle Borowsky, MD
• Carly Ann Bosco
• Gianna Bosco, MD
• Kyle Boudreau
• Kristine Bowersox, PA-C

• Mental Health Counselor in Park Ridge, IL
• Providers in Park Ridge, IL by specialty
• Mental Health Counselor in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 14, 2009; 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.