Individual provider Active NPI

Jonathan Senderak, MA, LPC, NCC, PEL-SC

  • Professional Counselor
  • Northbrook, IL
National Provider Identifier
1053857300
Registry record updated Mar 17, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
178.010546 Issued in IL
Practice address
617 Landwehr Rd
Northbrook, IL 60062-2309
Phone
(224) 723-5772
NPI assigned
Jan 10, 2017
Last updated
Mar 17, 2018By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 17, 2018

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 178.010546 IL Primary

Addresses

Primary practice location

617 Landwehr Rd
Northbrook, IL 60062-2309

Mailing address

617 Landwehr Rd
Northbrook, IL 60062-2309

Other practice location 1

350 Pfingsten Rd
Northbrook, IL 60062-2032
Phone (224) 723-5772

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
Credentials
Master of Arts

State licenses

LicenseStateTypeSpecialty
178.010546ILMDProfessional Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Brighter Pathways PLLC 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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1484006400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1521244800000",
    "number": "1053857300",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "617 LANDWEHR RD",
            "city": "NORTHBROOK",
            "state": "IL",
            "postal_code": "600622309"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "617 LANDWEHR RD",
            "city": "NORTHBROOK",
            "state": "IL",
            "postal_code": "600622309",
            "telephone_number": "224-723-5772"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "350 Pfingsten Rd",
            "address_purpose": "LOCATION",
            "city": "Northbrook",
            "state": "IL",
            "postal_code": "600622032",
            "country_code": "US",
            "telephone_number": "224-723-5772",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SENDERAK",
        "first_name": "JONATHAN",
        "credential": "MA, LPC, NCC, PEL-SC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-01-10",
        "last_updated": "2018-03-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "IL",
            "license": "178.010546",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Northbrook, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 17, 2018; 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.