Active NPI
Nicolette Taylor, LPC
- Mental Health Counselor
- Homewood, IL
National Provider Identifier
1003479460
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Mental Health Counselor
- License
- 178014443
- Practice address
- 935 175TH St
Homewood, IL 60430-2049 - Phone
- (312) 388-1505
- NPI assigned
- Apr 20, 2019
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | 178014443 | IL | Primary |
Addresses
Primary practice location
935 175TH St
Homewood, IL 60430-2049
Mailing address
935 175TH St
Homewood, IL 60430-2049
Phone (312) 388-1505
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 178014443 | IL | MD | Mental Health Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1555718400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1555718400000",
"number": "1003479460",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "935 175TH ST",
"city": "HOMEWOOD",
"state": "IL",
"postal_code": "604302049",
"telephone_number": "312-388-1505"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "935 175TH ST",
"city": "HOMEWOOD",
"state": "IL",
"postal_code": "604302049",
"telephone_number": "312-388-1505"
}
],
"practiceLocations": [],
"basic": {
"last_name": "TAYLOR",
"first_name": "NICOLETTE",
"credential": "LPC",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2019-04-20",
"last_updated": "2019-04-20",
"status": "A"
},
"taxonomies": [
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": "IL",
"license": "178014443",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Homewood, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 20, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.