NPIMap

Organization Active NPI

Green Door Therapy LLC

  • Mental Health Counselor
  • Elmhurst, IL
National Provider Identifier
1982195301
Registry record updated Nov 9, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
Legal business name
GREEN DOOR THERAPY LLC
Practice address
126 N York St Ste 2
Elmhurst, IL 60126-2888
Phone
(163) 038-4956
NPI assigned
May 21, 2018
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 9, 2021

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

Authorized official

Name
Brooke Madera, MS, LCPC, CADCNPI 1902234412
Title
Clinical Therapist/ Supervisor
Phone
(630) 384-9560

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 3

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) CounselorGroup: 193200000X MULTI-SPECIALTY GROUP 101YA0400X
Mental Health CounselorGroup: 193200000X MULTI-SPECIALTY GROUP 101YM0800X Primary
Community/Behavioral Health Agency 251S00000X

Addresses

Primary practice location

126 N York St Ste 2
Elmhurst, IL 60126-2888

Mailing address

PO Box 7109
Villa Park, IL 60181-7109

National Provider Directory

National Provider Directory

Locations

126 N York St
Ste 2
Elmhurst, IL 60126
Phone (630) 384-9560

320 S Cornell Ave
Ste B
Villa Park, IL 60181
Phone (330) 714-3869

Practitioners & affiliated clinicians

Practitioners 5

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": "1526860800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1636416000000",
    "number": "1982195301",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 7109",
            "city": "VILLA PARK",
            "state": "IL",
            "postal_code": "601817109"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "126 N YORK ST STE 2",
            "city": "ELMHURST",
            "state": "IL",
            "postal_code": "601262888",
            "telephone_number": "163-038-4956"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GREEN DOOR THERAPY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-05-21",
        "last_updated": "2021-11-09",
        "certification_date": "2021-11-09",
        "status": "A",
        "authorized_official_last_name": "MADERA",
        "authorized_official_first_name": "BROOKE",
        "authorized_official_title_or_position": "CLINICAL THERAPIST/ SUPERVISOR",
        "authorized_official_telephone_number": "630-384-9560",
        "authorized_official_credential": "MS, LCPC, CADC"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Elmhurst, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 9, 2021; 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.