Prairie River Counseling and Consulting, LLC

Primary specialty

Community/Behavioral Health AgencyTaxonomy code 251S00000X

License

149018807 Issued in IL

Legal business name

PRAIRIE RIVER COUNSELING AND CONSULTING, LLC

Practice address

310 N Convent St
Suite 3
Bourbonnais, IL 60914-2099

Phone

(815) 304-4948

NPI assigned

Jan 27, 2017

Organization subpart

No

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

Authorized official

Name

Ms. Mary Therese Boyle, LCSW

Title

Manager

Phone

(815) 304-4948

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1485475200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1487721600000",
    "number": "1982141032",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "310 N CONVENT ST",
            "address_2": "SUITE 3",
            "city": "BOURBONNAIS",
            "state": "IL",
            "postal_code": "609142099",
            "telephone_number": "815-304-4948"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "310 N CONVENT ST",
            "address_2": "SUITE 3",
            "city": "BOURBONNAIS",
            "state": "IL",
            "postal_code": "609142099",
            "telephone_number": "815-304-4948"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PRAIRIE RIVER COUNSELING AND CONSULTING, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-01-27",
        "last_updated": "2017-02-22",
        "status": "A",
        "authorized_official_last_name": "BOYLE",
        "authorized_official_first_name": "MARY",
        "authorized_official_middle_name": "THERESE",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "815-304-4948",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "LCSW"
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": "IL",
            "license": "149018807",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Margaret Ann Piper, MA, LCPC
• Thomas M Potoski, LCPC
• Nicole Potts
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• Kristen Powell
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• Community/Behavioral Health Agency in Bourbonnais, IL
• Providers in Bourbonnais, IL by specialty
• Community/Behavioral Health Agency in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 22, 2017; 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.