NPIMap

Antonio Tomas Acevedo, LPC, MA

Individual provider Active NPI Mental Health Counselor · Evanston, IL

NPI 1013776277 · NPPES record last updated Mar 18, 2024

Key facts

NPI
1013776277
Entity type
Individual (NPI type 1)
Primary specialty
Mental Health Counselor 101YM0800X
License
178.020026 (IL)
Practice address
622 Davis St
Evanston, IL 60201-4491
Phone
(773) 294-0176
NPI assigned
Mar 18, 2024
Sex
Male
Sole proprietor
No

Organizations & group practices 1

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.

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No
Credentials
Master of Arts

State licenses

LicenseStateTypeSpecialty
178.020026ILMDMental Health Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Tracy Nieman LLC Current
since Mar 24, 2024		 Accepting new patients

Locations

622 Davis St
Evanston, IL 60201
Phone (773) 294-0176

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X 178.020026 IL Yes

Addresses

Primary practice location

622 Davis St
Evanston, IL 60201-4491

Mailing address

622 Davis St
Evanston, IL 60201-4491
Phone (773) 294-0176

Other providers in Evanston, IL

All providers in Evanston, IL · Mental Health Counselor in Illinois

Sources for this page

Verify at the official NPI Registry.