GREAT LAKES NEUROPSYCHOLOGY & COUNSELING LLC
NPI 1013030725
Psychologist - Clinical in Rockford, IL

Q: What is Great Lakes Neuropsychology & Counseling LLC's specialty?

The primary specialty registered for this NPI is Psychologist, specializing in Clinical, with taxonomy code 103TC0700X.

Active since April 09, 2007

5758 ELAINE DR, ROCKFORD, IL 61108(815) 231-1280(815) 231-1282 Get Directions Write a Review

NPPES record last updated: February 5, 2008. Verified against the NPPES registry weekly; last sync: August 16, 2026.

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About Great Lakes Neuropsychology & Counseling Llc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

GREAT LAKES NEUROPSYCHOLOGY & COUNSELING LLC (NPI 1013030725) is a healthcare organization registered as a clinical in Rockford, Illinois and active in the NPI registry since April 2007. The organization lists Shaun A Bong, Licensed Clinical Psychologist/memb, as its authorized official.

NPPES Registry Identity

NPI1013030725

Entity TypeOrganization

Primary Taxonomy103TC0700X

Legal Business NameGREAT LAKES NEUROPSYCHOLOGY & COUNSELING LLC

Location Address5758 ELAINE DRRockford, IL 61108-3102

Mailing Address5758 Elaine DrRockford, IL 61108-3102 · (815) 231-1280 · Fax (815) 231-1282

Phone(815) 231-1280

Fax(815) 231-1282

Organization SubpartNo

Authorized OfficialShaun A BongLicensed Clinical Psychologist/memb · (815) 231-1280

Enumeration DateApril 9, 2007

Last NPPES UpdateFebruary 5, 2008

✔ NPI 1013030725 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyPsychologist · ClinicalBehavioral Health & Social Service Providers

Taxonomy Code103TC0700X

Definition

A psychologist who provides continuing and comprehensive mental and behavioral health care for individuals and families; consultation to agencies and communities; training, education and supervision; and research-based practice. It is a specialty in breadth -- one that is broadly inclusive of severe psychopathology -- and marked by comprehensiveness and integration of knowledge and skill from a broad array of disciplines within and outside of psychology proper. The scope of clinical psychology encompasses all ages, multiple diversities and varied systems.

Also ListedClinical NeuropsychologistTaxonomy 103G00000X

5758 ELAINE DR, Rockford, IL 61108

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Other Identifiers 1

Other215368IL · Medicare Ptan

Group Practice 1

Group TaxonomyThis provider is a business group of one or more individual practitioners, who practice with different areas of specialization.193200000X MULTI-SPECIALTY GROUP

Other Providers at the Same Location NPPES

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

MARTHA CROTTS

Psychiatry & Neurology (Child & Adolescent Psychiatry)

5758 ELAINE DR
ROCKFORD, IL 61108

Winnebago County (815) 395-1008

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Great Lakes Neuropsychology & Counseling LLC's NPI number?

The NPI number for Great Lakes Neuropsychology & Counseling LLC is 1013030725. It was assigned to this organization in the NPPES registry on April 9, 2007.

Where is Great Lakes Neuropsychology & Counseling LLC located?

Great Lakes Neuropsychology & Counseling LLC is located at 5758 Elaine Dr, Rockford, IL 61108. The listed phone number is (815) 231-1280.

What is Great Lakes Neuropsychology & Counseling LLC's specialty?

The primary specialty registered for this NPI is Psychologist, specializing in Clinical, with taxonomy code 103TC0700X.

When was this NPI record last updated?

The NPPES record for Great Lakes Neuropsychology & Counseling LLC was last updated on February 5, 2008. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 18 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.