Healthcare Provider Details

I. General information

NPI: 1639700743
Provider Name (Legal Business Name): BOSHARDY COUNSELING & CONSULTING LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/28/2020
Last Update Date: 09/15/2026
Certification Date: 09/15/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3027 N ELBRIDGE AVE
CHICAGO IL
60618-6721
US

IV. Provider business mailing address

3027 N ELBRIDGE AVE
CHICAGO IL
60618-6721
US

V. Phone/Fax

Practice location:
  • Phone: 217-622-7983
  • Fax: 773-303-8429
Mailing address:
  • Phone: 217-622-7983
  • Fax: 773-303-8429

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101Y00000X
TaxonomyCounselor
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State
# 4
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number
License Number State

VIII. Authorized Official

Name: CAITLIN BOSHARDY
Title or Position: OWNER AND THERAPIST
Credential: LCPC
Phone: 217-622-7983