PROVIDENCE COUNSELING ASSOCIATES, LLC (NPI# 1861523680) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1861523680 |
| Entity Type | Organization |
| Organization Name | PROVIDENCE COUNSELING ASSOCIATES, LLC |
| Practice Address |
445 W Jackson Ave Ste 206 Naperville IL 60540-5258 |
| Practice Telephone | 6304202596 |
| Practice Fax Number | 6304202796 |
| Mailing Telephone | 6304202596 |
| Mailing Fax Number | 6304202796 |
| Enumeration Date | 2007-03-07 |
| Last Update Date | 2009-03-10 |
| Authorized Official Name | DR. STEPHANIE JOY SPACKEY (MANAGING MEMBER) |
| Authorized Official Telephone | 6304202596 |
| Authorized Official Credential | PSY.D. |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 103T00000X | Psychologist | IL | Behavioral Health & Social Service Providers | |
| Y | 101YP2500X |
Counselor Specialization: Professional |
IL | Behavioral Health & Social Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| IL | BLUECROSSBLUESHIELD | 0032240364 | 01 |
| Street Address |
445 W JACKSON AVE STE 206 |
| City | NAPERVILLE |
| State | IL |
| Zip Code | 60540-5258 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1770763393 | Lindsay B Harris | Counselor | 445 W Jackson Ave Ste 206, Naperville, IL 60540-5258 | 2007-11-12 |
| 1306048772 | Stephanie J. Spackey, Ltd. | Psychologist | 445 W Jackson Ave Ste 206, Naperville, IL 60540-5258 | 2007-06-05 |
| 1962621540 | Charlene R Brower | Psychologist | 445 W Jackson Ave Ste 206, Naperville, IL 60540-5258 | 2007-04-24 |
| 1013136688 | Stephanie Spackey | Psychologist | 445 W Jackson Ave Ste 206, Naperville, IL 60540-5258 | 2007-04-24 |
| 1891826582 | Diann Anderson | Counselor | 445 W Jackson Ave Ste 206, Naperville, IL 60540-5258 | 2007-03-07 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1760007678 | Mandalai Oral and Maxillofacial Surgery PC | Oral & Maxillofacial Surgery | 720 S. Brom Drive Suite 103, Naperville, IL 60540 | 2020-06-16 |
| 1316418957 | James Edward Frank | Counselor | 600 South Washington Street, Suite 302, Naperville, IL 60540 | 2018-12-07 |
| 1093208332 | Ingrid Johnson | Developmental Therapist | Right Start Pediatric Therapies, 50 S Main St Suite 200, Naperville, IL 60540 | 2018-06-12 |
| 1225528524 | Tara Rada Nieberding | Contractor | 1701 Quincy Ave Ste 12, Naperville, IL 60540 | 2018-05-14 |
| 1588182190 | Debra Xiangjun Hayes | Acupuncturist | 226 N Washington St # 2, Naperville, IL 60540 | 2017-09-03 |
| 1487197166 | Health Improvement and Preventive Services LLC | Family Medicine | 1979 Mcdowell Rd., Suite 103, Naperville, IL 60540 | 2016-11-29 |
| 1588013775 | Matthew Jacob Imber | Chiropractor | 1220 Hobson Rd Ste 220, Naperville, IL 60540 | 2016-06-08 |
| 1457711418 | Elite Pain Medical Group Inc | Physical Medicine & Rehabilitation | 720 South Brom Drive, Suite 201, Naperville, IL 60540 | 2016-03-03 |
| 1265814800 | Jenifer Lynn Mersman | Chiropractor | 475 River Bend Rd. Suite 104, Naperville, IL 60540 | 2015-06-19 |
| 1386038016 | Jonathon Martin Ruiz | Specialist/Technologist | 440 N Brainard Street, Naperville, IL 60540 | 2015-03-19 |
| Find all providers in zip 60540 | ||||
| Taxonomy Code | 101YP2500X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Counselor |
| Specialization | Professional |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1932706371 | Rakhi Shingala | Counselor | Legacy Clinical Consultant, 13717 S. Route 30, 159, Naperville, IL 60544 | 2020-10-08 |
| 1821603895 | Laura M Murray | Counselor | 2712 Forgue Dr Ste 112, Naperville, IL 60564-4230 | 2020-09-15 |
| 1801408935 | Gina Dickison | Counselor | 2311 Bill Ct, Naperville, IL 60565-5240 | 2020-08-19 |
| 1528683208 | Linda Puetz | Counselor | 23w281 Hampton Cir, Naperville, IL 60540-9424 | 2020-06-09 |
| 1134755416 | Courtney Krishona Berry | Counselor | 2211 Waterleaf Ct Unit 202, Naperville, IL 60564-4969 | 2020-03-18 |
| 1710526843 | Jamie M Miles Haynes | Counselor | 4295 Gardenview Dr Apt 211, Naperville, IL 60564-1648 | 2020-01-06 |
| 1780222331 | Ellen R Kuefler | Counselor | 1129 Big Foot Ln, Naperville, IL 60563-2470 | 2019-12-13 |
| 1033773213 | Chelsea Bogda | Counselor | 1754 N Washington St Ste 104a, Naperville, IL 60563-1462 | 2019-04-23 |
| 1811450208 | Jessica L. Kush | Counselor | 29 S Webster St Ste 106, Naperville, IL 60540-5353 | 2019-04-11 |
| 1427511518 | Takeisha Rheams | Counselor | 500 E Ogden Ave Ste 101, Naperville, IL 60563-3264 | 2019-04-07 |
| Find all providers in NAPERVILLE | ||||
| City | NAPERVILLE |
| Zip Code | 60540 |
Please comment or provide details below to improve the information on PROVIDENCE COUNSELING ASSOCIATES, LLC.
| 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.