Active NPI
Ngozi Harris, LCPC
- Counselor
- Blue Island, IL
National Provider Identifier
1023476769
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Counselor
- License
- 180.009873
- Practice address
- 12510 Vincennes Rd
Unit 4
Blue Island, IL 60406-1674 - Phone
- (708) 691-9424
- NPI assigned
- Feb 9, 2016
- Sex
- Female
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Counselor | 101Y00000X | 180.009873 | IL | Primary |
Addresses
Primary practice location
12510 Vincennes Rd
Unit 4
Blue Island, IL 60406-1674
Mailing address
12510 Vincennes Rd
Unit 4
Blue Island, IL 60406-1674
Phone (708) 691-9424
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 |
|---|---|---|---|
| 180.009873 | IL | MD | Counselor |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Create Your Story | Counselor | Past | Accepting new patients |
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.
-
- Professional Counselor
- Markham, IL
- NPI 1477306470
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1454976000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1454976000000",
"number": "1023476769",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "12510 VINCENNES RD",
"address_2": "UNIT 4",
"city": "BLUE ISLAND",
"state": "IL",
"postal_code": "604061674",
"telephone_number": "708-691-9424"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "12510 VINCENNES RD",
"address_2": "UNIT 4",
"city": "BLUE ISLAND",
"state": "IL",
"postal_code": "604061674",
"telephone_number": "708-691-9424"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HARRIS",
"first_name": "NGOZI",
"credential": "LCPC",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2016-02-09",
"last_updated": "2016-02-09",
"status": "A"
},
"taxonomies": [
{
"code": "101Y00000X",
"taxonomy_group": "",
"desc": "Counselor",
"state": "IL",
"license": "180.009873",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Blue Island, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 9, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.