JUDSON UNIVERSITY (NPI# 1356860571) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1356860571 |
| Entity Type | Organization |
| Organization Name | JUDSON UNIVERSITY |
| Practice Address |
1151 N State St Elgin IL 60123-1404 |
| Practice Telephone | 8476282464 |
| Practice Fax Number | 8476282044 |
| Mailing Telephone | 8476282464 |
| Mailing Fax Number | 8476282044 |
| Enumeration Date | 2017-09-19 |
| Last Update Date | 2017-09-19 |
| Authorized Official Name | CAROL DIDOMINICIS (CLINICAL SUPERVISOR) |
| Authorized Official Telephone | 8476282464 |
| Authorized Official Credential | LCSW |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 261QM1300X |
Clinic/Center Specialization: Multi-Specialty |
Ambulatory Health Care Facilities | ||
| Y | 251S00000X | Community/Behavioral Health | Agencies |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| NONE | NONE | 01 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| System for Award Management (SAM) Entities | JUDSON UNIVERSITY | 1151 N State St, Elgin, IL 60123-1404 |
| Street Address |
1151 N STATE ST |
| City | ELGIN |
| State | IL |
| Zip Code | 60123-1404 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1124658893 | Sara Brunsting | Counselor | 1151 N State St, Elgin, IL 60123-1498 | 2020-01-22 |
| 1376033241 | Maria K Rim | Social Worker | 1151 N State St, Elgin, IL 60123-1404 | 2018-05-15 |
| 1437365046 | Marsha J. Vaughn | Marriage & Family Therapist | 1151 N State St, Elgin, IL 60123 | 2007-05-14 |
| 1306828645 | Jay Patrick Anderson | Specialist/Technologist | 1151 N State St, Elgin, IL 60123-1404 | 2005-11-14 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1629625736 | Edna Lopez | Social Worker | 1140 N. Mclean Blvd #1, Elgin, IL 60123 | 2019-08-22 |
| 1003472259 | Katelyn Lee O'connell | Counselor | 695 S. Sate Street, Elgin, IL 60123 | 2019-05-14 |
| 1598235152 | Katie Elizabeth Dwyer | Counselor | 695 S. State Street, Elgin, IL 60123 | 2018-11-27 |
| 1174002778 | James M Accetta | Counselor | 52 Surry Drive, Elgin, IL 60123 | 2018-08-14 |
| 1770086175 | Griswold Home Care | Adult Companion | 707 A Davis Road, Suite 203, Elgin, IL 60123 | 2018-03-12 |
| 1003315706 | Danielle Bryant | Nurse Practitioner | 745 Fletcher Dr Ste 101, Elgin, IL 60123 | 2018-02-08 |
| 1912421470 | Deborah Foshager | Counselor | 680 Shenandoah Trail, Elgin, IL 60123 | 2017-07-26 |
| 1760903470 | Miguel Camargo | Specialist/Technologist | 12 N Aldine St, Elgin, IL 60123 | 2017-07-03 |
| 1134658594 | David Sommer | Counselor | 1460 Umbdenstock Rd, Elgin, IL 60123 | 2017-06-08 |
| 1649719618 | Faheem Unisa Syed | Clinical Nurse Specialist | 1990 Larkin Ave., Elgin, IL 60123 | 2017-02-23 |
| Find all providers in zip 60123 | ||||
| Taxonomy Code | 251S00000X |
| Grouping | Agencies |
| Classification | Community/Behavioral Health |
| A private or public agency usually under local government jurisdiction, responsible for assuring the delivery of community based mental health, mental retardation, substance abuse and/or behavioral health services to individuals with those disabilities. Services may range from companion care, respite, transportation, community integration, crisis intervention and stabilization, supported employment, day support, prevocational services, residential support, therapeutic and supportive consultation, environmental modifications, intensive in-home therapy and day treatment, in addition to traditional mental health and behavioral treatment. |
| Notes: Source: National Medicaid EDI HIPAA NPI Sub Work Group [1/1/2007: modified definition] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1740743426 | Life Advocates LLC | Community/Behavioral Health | 525 Silver Spoon Ln, Elgin, SC 29045-7102 | 2019-04-10 |
| 1184183873 | Daystar Counseling & Consulting Services, LLC | Community/Behavioral Health | 7846 Us-277, Suite 3, Elgin, OK 73538 | 2019-03-13 |
| 1396168233 | Association for Individual Development | Community/Behavioral Health | 695 S State St, Elgin, IL 60123 | 2014-01-29 |
| 1710222823 | Youth Service Bureau of Illinois Valley | Community/Behavioral Health | 40 Du Page Ct Ste 400, Elgin, IL 60120-6418 | 2012-11-29 |
| 1477832244 | Summit Schools, Inc. | Community/Behavioral Health | 333 W River Rd, Elgin, IL 60123-1572 | 2011-08-11 |
| 1740507821 | Northwest Treatment Associates | Community/Behavioral Health | 1185 Dundee Ave Ste E1, Elgin, IL 60120-2233 | 2010-04-28 |
| 1811190564 | Kairos Family Center, Inc. | Community/Behavioral Health | 240 Standish St, Elgin, IL 60123-6421 | 2007-06-08 |
| 1346736204 | Phoenix Family Center, LLC | Community/Behavioral Health | 474 Summit St, Elgin, IL 60120-3829 | 2018-07-03 |
| 1730629924 | Association for Individual Development | Community/Behavioral Health | 120 S State St, Elgin, IL 60123-6403 | 2017-03-07 |
| 1790225050 | It's About Change Sober Living, Inc. | Community/Behavioral Health | 995 Bode Rd, Elgin, IL 60120-4523 | 2017-03-06 |
| Find all providers in ELGIN | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.