Nicole Romana Clarizio, LCPC

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

180007600 Issued in IL

Practice address

6300 Kingery Hwy Ste 102
Willowbrook, IL 60527-2250

Phone

(815) 469-1500

NPI assigned

Feb 25, 2009

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other names 1

• Nicole Kostaken Former name

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.

• Community Support Services

  • Social Worker
  • Brookfield, IL
  • NPI 1316036486
  NPD (past)
• Westside Childrens Therapy

  • Physical Therapist
  • Joliet, IL
  • NPI 1972783900
  NPD (past)

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

{
    "created_epoch": "1235520000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1595980800000",
    "number": "1023258449",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "139 N WILMETTE AVE",
            "city": "WESTMONT",
            "state": "IL",
            "postal_code": "605591730",
            "telephone_number": "630-567-0516"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6300 KINGERY HWY STE 102",
            "city": "WILLOWBROOK",
            "state": "IL",
            "postal_code": "605272250",
            "telephone_number": "815-469-1500"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "9021 Ogden Ave",
            "address_purpose": "LOCATION",
            "city": "Brookfield",
            "state": "IL",
            "postal_code": "605132040",
            "country_code": "US",
            "telephone_number": "630-567-0516",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CLARIZIO",
        "first_name": "NICOLE",
        "middle_name": "ROMANA",
        "name_prefix": "Mrs.",
        "credential": "LCPC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-02-25",
        "last_updated": "2020-07-29",
        "certification_date": "2020-07-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "IL",
            "license": "178005304",
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "IL",
            "license": "180007600",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "NICOLE",
            "last_name": "KOSTAKEN",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Chirosource, LTD.
• Howard Chiu, DPT
• Sonal N Choudhary
• Angelica Nicole Chrzascik
• Ben Chunprapaph, D,D,S.
• Alma Claudio, APRN
• Dana Clayter
• Vanessa Diaz Cloud
• Benjamin Colletti, DAT, LAT, ATC
• Samantha Collins, FNP

• Mental Health Counselor in Willowbrook, IL
• Providers in Willowbrook, IL by specialty
• Mental Health Counselor in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 29, 2020; 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.