COMMON BOUNDARY WELLNESS CENTER - NPI 1619189594

Q: What is the provider's specialty?

The provider's specialty is Counselor with taxonomy code 101YM0800X and a focus in Mental Health.

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About Common Boundary Wellness Center NPPES

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

COMMON BOUNDARY WELLNESS CENTER (NPI 1619189594) is a healthcare organization registered as a mental health in Rockford, Illinois and active in the NPI registry since May 2007. The organization lists Renee A Mcardle, Managing Partner, as its authorized official.

NPPES Registry Identity

NPI1619189594

Entity TypeOrganization

Primary Taxonomy101YM0800X

Legal Business NameCOMMON BOUNDARY WELLNESS CENTER

Location Address1495 NORTHROCK CTRockford, IL 61103-1233

Mailing Address1495 Northrock CtRockford, IL 61103-1233 · (815) 965-1817 · Fax (815) 965-9574

Phone(815) 965-1817

Fax(815) 965-9574

Organization SubpartNo

Authorized OfficialRenee A McardleManaging Partner · (815) 965-1817

Enumeration DateMay 4, 2007

Last NPPES UpdateAugust 22, 2020

✔ NPI 1619189594 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyCounselor · Mental HealthBehavioral Health & Social Service Providers

Taxonomy Code101YM0800X

1495 NORTHROCK CT, Rockford, IL 61103

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Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

Other Providers at the Same Location NPPES 5

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

DR. WILLIAM WYATT WOOD M.D.

Psychiatry & Neurology (Psychiatry)