Active NPI
Marissa Woods
- Professional Counselor
- Evanston, IL
National Provider Identifier
1083374524
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Professional Counselor
- License
- 178003926
- Practice address
- 2645 Lawndale Ave
Evanston, IL 60201-1179 - Phone
- (847) 691-7885
- NPI assigned
- Dec 24, 2021
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Professional Counselor | 101YP2500X | 178003926 | IL | Primary |
Addresses
Primary practice location
2645 Lawndale Ave
Evanston, IL 60201-1179
Mailing address
2645 Lawndale Ave
Evanston, IL 60201-1179
Phone (847) 691-7885
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
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Mental Health Counselor
- Education
- Other, 1999
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Telehealth
- Offers telehealth services
- Group practices
Practice addresses (Care Compare)
89 Evergreen CT
Deerfield, IL 60015-5066
Phone (773) 307-4501
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Master of Science
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 178003926 | IL | MD | Professional Counselor |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Anchor Health Counseling LLC | Current | Accepting new patients | |
| Richard Kneip, PH.D., P.C. | Past | Accepting new patients |
Organizations & group practices 2
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.
-
- General Practice Physician
- Deerfield, IL
- NPI 1760296560
-
- Community/Behavioral Health Agency
- Clarkston, MI
- NPI 1679739700
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1640304000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1640304000000",
"number": "1083374524",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2645 LAWNDALE AVE",
"city": "EVANSTON",
"state": "IL",
"postal_code": "602011179",
"telephone_number": "847-691-7885"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2645 LAWNDALE AVE",
"city": "EVANSTON",
"state": "IL",
"postal_code": "602011179",
"telephone_number": "847-691-7885"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WOODS",
"first_name": "MARISSA",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2021-12-24",
"last_updated": "2021-12-24",
"certification_date": "2021-12-24",
"status": "A"
},
"taxonomies": [
{
"code": "101YP2500X",
"taxonomy_group": "",
"desc": "Counselor, Professional",
"state": "IL",
"license": "178003926",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Evanston, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 24, 2021; 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.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.