Tina Villis, MA, LCPC
Individual provider Active NPI Counselor · Geneva, IL
NPI 1114150554 · NPPES record last updated Apr 13, 2015
Key facts
- NPI
- 1114150554
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Counselor 101Y00000X
- License
- 180.007247 (IL)
- Practice address
- 825 W State St
103D
Geneva, IL 60134-2080 - Phone
- (773) 627-1681
- NPI assigned
- Sep 2, 2009
- Sex
- Female
- Sole proprietor
- Yes
Organizations & group practices 1
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
- Credentials
- Master of Arts
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 180.007247 | IL | MD | Counselor |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Panahi Counseling, PC | Counselor | Past | Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Counselor | 101Y00000X | 180.007247 | IL | Yes |
Addresses
Primary practice location
825 W State St
103D
Geneva, IL 60134-2080
Mailing address
825 W State St
103D
Geneva, IL 60134-2080
Phone (773) 627-1681
Other providers in Geneva, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Apr 13, 2015. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.