Individual provider Active NPI

Nathalia Henrickson

  • Professional Counselor
  • Waukegan, IL
National Provider Identifier
1043978869
Registry record updated Nov 30, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
Practice address
415 Washington St Ste 200
Waukegan, IL 60085-5564
Phone
(224) 480-4642
NPI assigned
Nov 30, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 30, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Professional Counselor 101YP2500X Primary

Addresses

Primary practice location

415 Washington St Ste 200
Waukegan, IL 60085-5564

Mailing address

1314 79TH St
Kenosha, WI 53143-5931
Phone (224) 542-8572

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL
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.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240813003291 IL Practitioner - Mental Health Counselor 2668910308 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
The Josselyn Center NFPGroup PAC ID 0840289740, 86 clinicians

Practice addresses (Care Compare)

1135 Skokie Blvd
Northbrook, IL 60062-4118
Phone (847) 441-5600

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
The Josselyn Center CurrentSince Jun 28, 2024 Accepting new patients
The Josselyn Center NFP CurrentSince Jun 28, 2024 Accepting new patients
The Josselyn Center NFP CurrentSince Dec 5, 2021 Accepting new patients
The Josselyn Center NFP Current Accepting new patients

Locations

1135 Skokie Blvd
Northbrook, IL 60062
Phone (773) 430-3351

405 Central Ave
Northfield, IL 60093
Phone (847) 441-5603

415 Washington St
Ste 200
Waukegan, IL 60085
Phone (224) 290-1259

Organizations & group practices 4

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": "1638230400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1638230400000",
    "number": "1043978869",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1314 79TH ST",
            "city": "KENOSHA",
            "state": "WI",
            "postal_code": "531435931",
            "telephone_number": "224-542-8572"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "415 WASHINGTON ST STE 200",
            "city": "WAUKEGAN",
            "state": "IL",
            "postal_code": "600855564",
            "telephone_number": "224-480-4642"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HENRICKSON",
        "first_name": "NATHALIA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-11-30",
        "last_updated": "2021-11-30",
        "certification_date": "2021-11-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Waukegan, IL

Sources for this page

Verify at the official NPI Registry.