Brian Smith McCallum

Primary specialty

CounselorTaxonomy code 101Y00000X

License

178.005657 Issued in IL

Practice address

9414 Route 176
Crystal Lake, IL 60014

Phone

(800) 361-6880

NPI assigned

Feb 9, 2012

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

Enrolled in IL

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Mental Health Counselor

Education

Other, 2007

Medicare assignment

May accept Medicare assignment

Telehealth

Offers telehealth services

Group practices

Woodstock Therapist LLCGroup PAC ID 6507133105, 4 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Woodstock Therapist LLC

  • Professional Counselor
  • Woodstock, IL
  • NPI 1003358037
  Medicare reassignment Care Compare group NPD
• Chicago Christian Counseling Center Inc

  • Clinical Social Worker
  • Orland Park, IL
  • NPI 1083664510
  NPD (past)

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

{
    "created_epoch": "1328745600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1328745600000",
    "number": "1962775734",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15127 S 73RD AVE",
            "address_2": "SUITE G",
            "city": "ORLAND PARK",
            "state": "IL",
            "postal_code": "604624398",
            "telephone_number": "800-361-6880"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9414 ROUTE 176",
            "city": "CRYSTAL LAKE",
            "state": "IL",
            "postal_code": "60014",
            "telephone_number": "800-361-6880"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCCALLUM",
        "first_name": "BRIAN",
        "middle_name": "SMITH",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-02-09",
        "last_updated": "2012-02-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": "IL",
            "license": "178.005657",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Elizabeth Kerry Mayes, AUD
• Emily Katherine Maynard
• James E MC Ginn Jr., DC
• Danya Michelle McArthur-Doudou
• Despina McBride, MA, LCPC
• Maureen Gloria McCarthy, MA, CCC/SLP-L
• Michelle Lynne McClellan, PSY D
• Caitlyn McClure, DSW, LCSW
• Richard Everett McCoy, D. C.
• Lucas C McCully, DC

• Counselor in Crystal Lake, IL
• Providers in Crystal Lake, IL by specialty
• Counselor in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 9, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.