Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Great Lakes Neuropsychology & Counseling LLC

Organization Clinical Neuropsychologist · NPI 1013030725

Great Lakes Neuropsychology & Counseling LLC is a Clinical Neuropsychologist in Rockford, Illinois. Licensed in Illinois. Registered with an NPI since 2007.

Licensed in
IL
In the registry since
2007
Specialties on file
4
What do these letters mean?
LLC — Limited liability company
A form of business registration, not a clinical qualification.

See every abbreviation used in this directory →

Practice location Address checks out

5758 Elaine Dr
Rockford, IL 61108-3102
Phone: (815) 231-1280
Fax: (815) 231-1282
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Clinical Psychologist (primary) Taxonomy 103TC0700X (IL)
Clinical Neuropsychologist Taxonomy 103G00000X (IL)
Clinical Neuropsychologist Taxonomy 103G00000X (IL)
Clinical Psychologist Taxonomy 103TC0700X (IL)

Record details

NPI number1013030725
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Shaun Bong — Licensed Clinical Psychologist/Memb · (815) 231-1280
NPI enumeratedApril 9, 2007
Last updated in NPPESFebruary 5, 2008
Mailing address5758 Elaine Dr, Rockford, IL 61108-3102