Active NPI
Michelle Gonwa Heyden, MAAT, LCPC
- Mental Health Counselor
- Chicago, IL
National Provider Identifier
1124036264
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Mental Health Counselor
- License
- 180.006189
- Practice address
- 180 N Michigan Ave
Suite 905
Chicago, IL 60601-7401 - Phone
- (312) 213-2226
- NPI assigned
- Aug 4, 2006
- 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 |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | 180.006189 | IL | Primary |
Addresses
Primary practice location
180 N Michigan Ave
Suite 905
Chicago, IL 60601-7401
Mailing address
2709 W Wellington Ave
Apt 1
Chicago, IL 60618-7822
Phone (312) 213-2226
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Opted out of Medicare
- Yes, effective Feb 1, 2024 through Feb 1, 2028
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 180.006189 | IL | MD | Mental Health Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1154649600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1243382400000",
"number": "1124036264",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2709 W WELLINGTON AVE",
"address_2": "APT 1",
"city": "CHICAGO",
"state": "IL",
"postal_code": "606187822",
"telephone_number": "312-213-2226"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "180 N MICHIGAN AVE",
"address_2": "SUITE 905",
"city": "CHICAGO",
"state": "IL",
"postal_code": "606017401",
"telephone_number": "312-213-2226"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HEYDEN",
"first_name": "MICHELLE",
"middle_name": "GONWA",
"name_prefix": "Ms.",
"credential": "MAAT, LCPC",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2006-08-04",
"last_updated": "2009-05-27",
"status": "A"
},
"taxonomies": [
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": "IL",
"license": "180.006189",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Chicago, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 27, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Opt Out Affidavits.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.