Scott Thomas Shippert, LCPC

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

180012224 Issued in IL

Practice address

15025 S Des Plaines St Ste 101
Plainfield, IL 60544-1868

Phone

(630) 428-7890

NPI assigned

Dec 6, 2018

Last updated

Jul 30, 2020By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

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

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• CS Pacs 3 Il, S.C.

  • Hospitalist Physician
  • Park Ridge, IL
  • NPI 1598577124
  Medicare reassignment NPD
• Edgewood Clinical Services, P.C.

  dba LifeStance

  • Psychologist
  • Naperville, IL
  • NPI 1295914646
  Medicare reassignment NPD
• Illinois Post-Acute Medical Services 1 PC

  • Hospitalist Physician
  • Hinsdale, IL
  • NPI 1952830853
  Medicare reassignment NPD
• Sinnissippi Centers, Inc.

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Rochelle, IL
  • NPI 1407143837
  Medicare reassignment NPD
• CS Pacs 3 Midwest LLC

  • Hospitalist Physician
  • Dayton, OH
  • NPI 1972368785

  IL

  Medicare reassignment NPD
• NV Pacs 2 LLC

  • Hospitalist Physician
  • Las Vegas, NV
  • NPI 1427534809

  IL

  Medicare reassignment NPD
• Sinnissippi Centers, Inc.

  • Mental Illness Community Based Residential Treatment Facility
  • Dixon, IL
  • NPI 1538447313
  NPD
• Sinnissippi Centers, Inc.

  • Substance Use Disorder Rehabilitation Clinic/Center
  • Dixon, IL
  • NPI 1922114115
  NPD
• Edgewood Clinical Services, P.C.

  dba LifeStance

  • Community/Behavioral Health Agency
  • Naperville, IL
  • NPI 1366784837
  NPD (past)
• Psychology Specialists LTD

  dba LifeStance Health

  • Clinical Psychologist
  • Bloomington, IL
  • NPI 1053368605
  NPD (past)

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

{
    "created_epoch": "1544054400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1596067200000",
    "number": "1053882704",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "106 S LINCOLNWAY STE F",
            "city": "NORTH AURORA",
            "state": "IL",
            "postal_code": "605421597",
            "telephone_number": "815-440-8492"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15025 S DES PLAINES ST STE 101",
            "city": "PLAINFIELD",
            "state": "IL",
            "postal_code": "605441868",
            "telephone_number": "630-428-7890"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "106 S Lincolnway",
            "address_purpose": "LOCATION",
            "city": "North Aurora",
            "state": "IL",
            "postal_code": "605421663",
            "country_code": "US",
            "telephone_number": "815-440-8492",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "222 E Willow Ave",
            "address_purpose": "LOCATION",
            "city": "Wheaton",
            "state": "IL",
            "postal_code": "601875426",
            "country_code": "US",
            "telephone_number": "773-297-3457",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SHIPPERT",
        "first_name": "SCOTT",
        "middle_name": "THOMAS",
        "credential": "LCPC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2018-12-06",
        "last_updated": "2020-07-30",
        "certification_date": "2020-07-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "IL",
            "license": "178.013200",
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "IL",
            "license": "180012224",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Erica Ann Shick, LCPC
• Alison Shin
• Douglas Charles Shindollar, D.D.S.
• Shining Smiles Plainfield Inc
• Shining Star Therapy, LLC
• Janina Shorter
• Stephanie Nicole Sierra, LPC
• Sigler Family Eye Care LLC
• Melissa K Sigler, OD
• Allison Jean Simek, APN, FNP-C

• Professional Counselor in Plainfield, IL
• Providers in Plainfield, IL by specialty
• Professional Counselor in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 30, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.