Active NPI
Nicole L Burlingame, LPC, LMHCA
- Mental Health Counselor
- West Chicago, IL
National Provider Identifier
1043976111
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Mental Health Counselor
- License
- MC61324701
- Practice address
- 0S438 Melolane Rd
West Chicago, IL 60185-3735 - Phone
- (847) 347-7812
- NPI assigned
- Nov 12, 2021
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Professional Counselor | 101YP2500X | 178.016786 | IL | |
| Mental Health Counselor | 101YM0800X | MC61324701 | WA | Primary |
Addresses
Primary practice location
0S438 Melolane Rd
West Chicago, IL 60185-3735
Mailing address
0S438 Melolane Rd
West Chicago, IL 60185-3735
Phone (847) 347-7812
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 |
|---|---|---|---|
| MC61324701 | WA | MD | Mental Health Counselor |
| 178.016786 | IL | MD | Professional Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1636675200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1662508800000",
"number": "1043976111",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "0S438 MELOLANE RD",
"city": "WEST CHICAGO",
"state": "IL",
"postal_code": "601853735",
"telephone_number": "847-347-7812"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "0S438 MELOLANE RD",
"city": "WEST CHICAGO",
"state": "IL",
"postal_code": "601853735",
"telephone_number": "847-347-7812"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BURLINGAME",
"first_name": "NICOLE",
"middle_name": "L",
"credential": "LPC, LMHCA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2021-11-12",
"last_updated": "2022-09-07",
"certification_date": "2022-09-02",
"status": "A"
},
"taxonomies": [
{
"code": "101YP2500X",
"taxonomy_group": "",
"desc": "Counselor, Professional",
"state": "IL",
"license": "178.016786",
"primary": false
},
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": "WA",
"license": "MC61324701",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in West Chicago, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 7, 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.