Individual provider Active NPI

James Visinaiz Jr., LCPC

  • Counselor
  • Bloomingdale, IL
National Provider Identifier
1033624630
Registry record updated Dec 6, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
CounselorTaxonomy code 101Y00000X
License
180.011064 Issued in IL
Practice address
121 Fairfield Way Ste 240
Bloomingdale, IL 60108-1559
Phone
(630) 309-2989
Fax
(630) 790-3804
NPI assigned
Dec 6, 2017
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 6, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Counselor 101Y00000X 180.011064 IL Primary

Addresses

Primary practice location

121 Fairfield Way Ste 240
Bloomingdale, IL 60108-1559

Mailing address

121 Fairfield Way Ste 240
Bloomingdale, IL 60108-1559
Phone (630) 309-2989

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.
Opted out of Medicare
Yes, effective Aug 18, 2025 through Aug 18, 2027

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
180.011064ILMDCounselor

Practice roles

OrganizationSpecialtyStatusNew patients
Behavioral Health & Counseling Services, PLLC PastSince Feb 1, 2022 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.

NPI Registry JSON

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

{
    "created_epoch": "1512518400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1512518400000",
    "number": "1033624630",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "121 FAIRFIELD WAY STE 240",
            "city": "BLOOMINGDALE",
            "state": "IL",
            "postal_code": "601081559",
            "telephone_number": "630-309-2989",
            "fax_number": "630-790-3804"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "121 FAIRFIELD WAY STE 240",
            "city": "BLOOMINGDALE",
            "state": "IL",
            "postal_code": "601081559",
            "telephone_number": "630-309-2989",
            "fax_number": "630-790-3804"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VISINAIZ",
        "first_name": "JAMES",
        "name_suffix": "Jr.",
        "credential": "LCPC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-12-06",
        "last_updated": "2017-12-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": "IL",
            "license": "180.011064",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bloomingdale, IL

Sources for this page

Verify at the official NPI Registry.