Sareena Green, LCPC

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

180.014266 Issued in IL

Practice address

7336 Randolph St Apt 2
Forest Park, IL 60130-1374

Phone

(708) 860-0240

NPI assigned

Mar 13, 2022

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 3

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• The Lighted Path Counseling LLC

  • Community/Behavioral Health Agency
  • Chicago, IL
  • NPI 1639802911
  NPD

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1647129600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1647129600000",
    "number": "1003564618",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7336 RANDOLPH ST APT 2",
            "city": "FOREST PARK",
            "state": "IL",
            "postal_code": "601301374",
            "telephone_number": "708-860-0240"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7336 RANDOLPH ST APT 2",
            "city": "FOREST PARK",
            "state": "IL",
            "postal_code": "601301374",
            "telephone_number": "708-860-0240"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GREEN",
        "first_name": "SAREENA",
        "credential": "LCPC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-03-13",
        "last_updated": "2022-03-13",
        "certification_date": "2022-03-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "IL",
            "license": "180.014266",
            "primary": false
        },
        {
            "code": "101YS0200X",
            "taxonomy_group": "",
            "desc": "Counselor, School",
            "state": "IL",
            "license": "833472",
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "IL",
            "license": "180.014266",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "https://sareena-green.clientsecure.me/",
            "affiliation": "N",
            "endpointDescription": "Practice Site",
            "use": "OTHER",
            "useDescription": "Other",
            "useOtherDescription": "Marketing",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "7336 Randolph St Apt 2",
            "city": "Forest Park",
            "state": "IL",
            "country_code": "US",
            "postal_code": "601301374",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

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• Erika Ann Harley

• Professional Counselor in Forest Park, IL
• Providers in Forest Park, IL by specialty
• Professional Counselor in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 13, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.