Individual provider Active NPI

Terry Lee D'Amico, MA, LCPC

  • Professional Counselor
  • Homer Glen, IL
National Provider Identifier
1083883870
Registry record updated Jun 11, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
180-005604 Issued in IL
Practice address
15750 S Bell Rd
Suite 2E
Homer Glen, IL 60491-8412
Phone
(708) 301-6311
Fax
(408) 228-0891
NPI assigned
Feb 26, 2008
Last updated
Jun 11, 2011By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 11, 2011

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 180-005604 IL Primary

Addresses

Primary practice location

15750 S Bell Rd
Suite 2E
Homer Glen, IL 60491-8412

Mailing address

12105 Meadowland Dr
Homer Glen, IL 60491-7832
Phone (708) 301-6311

Other names 1

  • D'Amico & Associates in Counseling Professional 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
180-005604ILMDProfessional Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Hope for Recovery Inc CurrentSince Jan 19, 2020 Accepting new patients

Locations

15750 S Bell Rd
Ste 1A
Homer Glen, IL 60491
Phone (855) 223-4673

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": "1203984000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1307750400000",
    "number": "1083883870",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12105 MEADOWLAND DR",
            "city": "HOMER GLEN",
            "state": "IL",
            "postal_code": "604917832",
            "telephone_number": "708-301-6311",
            "fax_number": "408-228-0891"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15750 S BELL RD",
            "address_2": "SUITE 2E",
            "city": "HOMER GLEN",
            "state": "IL",
            "postal_code": "604918412",
            "telephone_number": "708-301-6311",
            "fax_number": "408-228-0891"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "D'AMICO",
        "first_name": "TERRY",
        "middle_name": "LEE",
        "credential": "MA, LCPC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-02-26",
        "last_updated": "2011-06-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "IL",
            "license": "180-005604",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "D'AMICO",
            "last_name": "COUNSELING",
            "middle_name": "& ASSOCIATES IN",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

Other providers in Homer Glen, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 11, 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.