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WATERFORD COUNSELING AND PSYCHOLOGICAL SERVICES, PC
NPI 1104250067
Psychologist - Clinical in Aurora, IL

Active since August 28, 2013
1256 WATERFORD DR, SUITE 140, AURORA, IL 60504(630) 898-5322(630) 898-5324 Get Directions Write a Review

NPPES record last updated: December 15, 2023. Verified against the NPPES registry weekly; last sync: October 25, 2026.

Record update history: Dec 15, 2023, Mar 10, 2023 (2 updates tracked since 2023).

About Waterford Counseling And Psychological Services, Pc NPPES

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

WATERFORD COUNSELING AND PSYCHOLOGICAL SERVICES, PC (NPI 1104250067) is a healthcare organization registered as a clinical in Aurora, Illinois and active in the NPI registry since August 2013. The organization maintains a secondary practice location in Oswego and lists Gary L Coleman, Clinical Psychologist, as its authorized official.

NPPES Registry Identity

NPI1104250067
Entity TypeOrganization
Primary Taxonomy103TC0700X
Legal Business NameWATERFORD COUNSELING AND PSYCHOLOGICAL SERVICES, PC
Location Address1256 WATERFORD DR, SUITE 140Aurora, IL 60504-4510
Mailing Address1256 Waterford Dr, Suite 140Aurora, IL 60504-4510 · (630) 898-5322 · Fax (630) 898-5324
Phone(630) 898-5322
Fax(630) 898-5324
Organization SubpartNo
Authorized OfficialGary L ColemanClinical Psychologist · (630) 898-5322
Enumeration DateAugust 28, 2013
Last NPPES UpdateDecember 15, 20232 updates tracked since enumeration
NPPES CertifiedDecember 15, 2023
✔ NPI 1104250067 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 4

★ Primary SpecialtyPsychologist · ClinicalBehavioral Health & Social Service Providers
Taxonomy Code103TC0700X
License✔ Licensed in IL · 071006641
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 ListedCounselor · ProfessionalTaxonomy 101YP2500X · License 180008137 (IL), 180007319 (IL)
Also ListedPsychologistTaxonomy 103T00000X
Also ListedSocial Worker · ClinicalTaxonomy 1041C0700X · License 149007223 (IL), 149007369 (IL)
1256 WATERFORD DR, Aurora, IL 60504
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Secondary Practice Location 1

Location 11022 Douglas RdOswego, IL 60543-5133 · Phone (630) 898-5322 · Fax (630) 636-6120

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

Medicare Participation & PECOS CMS

Medicare enrollment and the clinicians who bill Medicare through this organization, from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Waterford Counseling And Psychological Services, Pc is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Clinicians Billing Medicare Through This Organization

19

Medicare enrollment records show 19 clinicians reassign Medicare billing to Waterford Counseling And Psychological Services, PC, which bills Medicare for the services they deliver. Of these, 5 practice at this address and 13 within 10 miles. They are listed nearest first.

Clinicians by Medicare Specialty 3

Clinical Social Worker10
Mental Health Counselor8
Clinical Psychologist1

Clinicians, nearest first (19)

Cinthya Valladares, LCPC
Mental Health Counselor
NPI 1558965129
1256 WATERFORD DR STE 140
Aurora, IL 60504
(630) 898-5322
✔ PECOS✔ Accepts MedicareSame address
Amy Coleman, LCSW
Clinical Social Worker
NPI 1033543871
1256 WATERFORD DR SUITE 140
Aurora, IL 60504
(630) 898-5322
✔ PECOS✔ Accepts MedicareSame address
Brandie Remke
Clinical Social Worker
NPI 1720427214
1256 WATERFORD DR SUITE 140
Aurora, IL 60504
(630) 898-5322
✔ PECOS✔ Accepts MedicareSame address
Denise Meyer, ED.D.
Mental Health Counselor
NPI 1538372305
1256 WATERFORD DR STE 140
Aurora, IL 60504
(513) 252-3607
✔ PECOS✔ Accepts MedicareSame address
Monika Leja
Mental Health Counselor
NPI 1124623947
1256 WATERFORD DR STE 140
Aurora, IL 60504
(630) 898-5322
✔ PECOS✔ Accepts MedicareSame address
Elizabeth Kingsbury-Puscas, MSW, LCSW, CPSD
Clinical Social Worker
NPI 1942852777
1022 DOUGLAS RD
Oswego, IL 60543
(630) 708-0802
✔ PECOS3.1 mi
Melissa Murillo, LSW
Clinical Social Worker
NPI 1164112918
2948 ARTESIAN RD STE 112
Naperville, IL 60564
(630) 428-7890
✔ PECOS3.4 mi
Thresa Caccavale, MSW
Clinical Social Worker
NPI 1134735681
1230 N HIGHLAND AVE
Aurora, IL 60506
(630) 966-4300
✔ PECOS✔ Accepts Medicare4.7 mi
Gitanjali Mahanti
Clinical Social Worker
NPI 1417456427
1230 N HIGHLAND AVE
Aurora, IL 60506
(630) 859-1291
✔ PECOS✔ Accepts Medicare4.7 mi
Sarah Ridenour, LCSW
Clinical Social Worker
NPI 1457562308
43 E JEFFERSON AVE SUITE 201B
Naperville, IL 60540
(630) 907-1735
✔ PECOS✔ Accepts Medicare6.9 mi
Gary Coleman, PSY. D.
Clinical Psychologist
NPI 1407994049
2114 DEERPATH RD
Aurora, IL 60506
(630) 907-1735
✔ PECOS✔ Accepts Medicare7.2 mi
Mary Mchugh-Chaljub, LCPC
Mental Health Counselor
NPI 1477812097
2114 DEERPATH RD
Aurora, IL 60506
(630) 907-1735
✔ PECOS✔ Accepts Medicare7.2 mi
Sarah Kieckhafer, LPC
Mental Health Counselor
NPI 1578105268
710 E OGDEN AVE STE 320
Naperville, IL 60563
(630) 848-0445
✔ PECOS✔ Accepts Medicare7.9 mi
Rachel Boros
Mental Health Counselor
NPI 1063054724
750 ESSINGTON RD
Joliet, IL 60435
(815) 729-2160
✔ PECOS15 mi
Alondra Gonzalez
Clinical Social Worker
NPI 1831820109
1131 DEEPHAVEN DR
Joliet, IL 60432
(815) 661-1524
✔ PECOS18 mi
Jenie Umana, LCSW
Clinical Social Worker
NPI 1497098313
9669 KENTON AVE STE 204
Skokie, IL 60076
(847) 485-6400
✔ PECOS✔ Accepts Medicare35 mi
Kelsey Lutz, MA, LPC
Mental Health Counselor
NPI 1366093775
508 N CENTER ST
Gardner, IL 60424
(815) 252-1151
✔ PECOS✔ Accepts Medicare37 mi
Kysa Epstein, LCPC
Mental Health Counselor
NPI 1235440728
900 NORTH SHORE DR STE 120
Lake Bluff, IL 60044
(847) 615-1698
✔ PECOS✔ Accepts Medicare43 mi
Josephine Wanki
Clinical Social Worker
NPI 1134676109
2611 WOODLAWN RD
Sterling, IL 61081
(815) 625-0013
✔ PECOS✔ Accepts Medicare72 mi

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

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 Waterford Counseling And Psychological Services, PC's NPI number?

The NPI number for Waterford Counseling And Psychological Services, PC is 1104250067. It was assigned to this organization in the NPPES registry on August 28, 2013.

Where is Waterford Counseling And Psychological Services, PC located?

Waterford Counseling And Psychological Services, PC is located at 1256 Waterford Dr Suite 140, Aurora, IL 60504. The listed phone number is (630) 898-5322.

What is Waterford Counseling And Psychological Services, PC's specialty?

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

Is Waterford Counseling And Psychological Services, PC enrolled in Medicare?

Yes. Waterford Counseling And Psychological Services, PC is registered in the Medicare PECOS enrollment system.

How many clinicians bill Medicare through Waterford Counseling And Psychological Services, PC?

According to the CMS Revalidation Reassignment List (October 2026 release), 19 clinicians in 3 Medicare specialties reassign their Medicare billing to Waterford Counseling And Psychological Services, PC. A reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for the clinician's services. The largest specialties are Clinical Social Worker (10), Mental Health Counselor (8) and Clinical Psychologist (1). Of these, 5 practice at this address and 13 within 10 miles. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

When was this NPI record last updated?

The NPPES record for Waterford Counseling And Psychological Services, PC was last updated on December 15, 2023. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 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.