Healthcare Provider Details

I. General information

NPI: 1184458333
Provider Name (Legal Business Name): UNBOUND COUNSELING SERVICES, PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/29/2024
Last Update Date: 05/05/2026
Certification Date: 05/05/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

999 SUTHERLAND DR
CRYSTAL LAKE IL
60014-8413
US

IV. Provider business mailing address

1911 W WILSON ST # 543
BATAVIA IL
60510-1680
US

V. Phone/Fax

Practice location:
  • Phone: 773-885-9894
  • Fax:
Mailing address:
  • Phone: 815-339-8752
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QM0801X
TaxonomyMental Health Clinic/Center (Including Community Mental Health Center)
License Number
License Number State

VIII. Authorized Official

Name: LAURA M MILLER
Title or Position: OWNER/THERAPIST
Credential: LCPC
Phone: 815-339-8752