Individual provider Active NPI

Ashley Elizabeth Anderson, M.A.

  • Counselor
  • South Holland, IL
National Provider Identifier
1063701704
Registry record updated Apr 4, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
CounselorTaxonomy code 101Y00000X
License
178.006667 Issued in IL
Practice address
401 E 162ND St Ste 209
Heritage Center: Refuge Christian Counseling
South Holland, IL 60473-2237
Phone
(708) 339-2769
Fax
(708) 339-6776
NPI assigned
Apr 4, 2011
Last updated
Apr 4, 2011By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 4, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Counselor 101Y00000X 178.006667 IL Primary

Addresses

Primary practice location

401 E 162ND St Ste 209
Heritage Center: Refuge Christian Counseling
South Holland, IL 60473-2237

Mailing address

401 East 162ND St. Suite 209
Heritage Center: Refuge Christian Counseling
South Holland, IL 60473-2237
Phone (708) 339-2769

Other names 1

  • Miss Ashley Elizabeth Thompson Former name

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
178.006667ILMDCounselor

NPI Registry JSON

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

{
    "created_epoch": "1301875200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1301875200000",
    "number": "1063701704",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "401 EAST 162ND ST. SUITE 209",
            "address_2": "HERITAGE CENTER: REFUGE CHRISTIAN COUNSELING",
            "city": "SOUTH HOLLAND",
            "state": "IL",
            "postal_code": "604732237",
            "telephone_number": "708-339-2769",
            "fax_number": "708-339-6776"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "401 E 162ND ST STE 209",
            "address_2": "HERITAGE CENTER: REFUGE CHRISTIAN COUNSELING",
            "city": "SOUTH HOLLAND",
            "state": "IL",
            "postal_code": "604732237",
            "telephone_number": "708-339-2769",
            "fax_number": "708-339-6776"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ANDERSON",
        "first_name": "ASHLEY",
        "middle_name": "ELIZABETH",
        "name_prefix": "Mrs.",
        "credential": "M.A.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-04-04",
        "last_updated": "2011-04-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": "IL",
            "license": "178.006667",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ASHLEY",
            "last_name": "THOMPSON",
            "middle_name": "ELIZABETH",
            "prefix": "MISS",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in South Holland, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 4, 2011; 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.