Individual provider Active NPI

Nancy L Gleaves, MA, LCPC, NCAC II

  • Professional Counselor
  • Evergreen Park, IL
National Provider Identifier
1124136197
Registry record updated May 27, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
180000863 Issued in IL
Practice address
3450 W Maple St RM 202
Evergreen Park, IL 60805-3043
Phone
(708) 422-2885
Fax
(708) 422-7161
NPI assigned
Aug 29, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 27, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) Counselor 101YA0400X 10523 IL
Professional Counselor 101YP2500X 180000863 IL Primary

Addresses

Primary practice location

3450 W Maple St RM 202
Evergreen Park, IL 60805-3043

Mailing address

3450 W Maple St RM 202
Evergreen Park, IL 60805-3043
Phone (708) 422-2885

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
10523ILMDAddiction (Substance Use Disorder) Counselor
180000863ILMDProfessional Counselor

NPI Registry JSON

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

{
    "created_epoch": "1156809600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1748304000000",
    "number": "1124136197",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3450 W MAPLE ST RM 202",
            "city": "EVERGREEN PARK",
            "state": "IL",
            "postal_code": "608053043",
            "telephone_number": "708-422-2885",
            "fax_number": "708-422-7161"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3450 W MAPLE ST RM 202",
            "city": "EVERGREEN PARK",
            "state": "IL",
            "postal_code": "608053043",
            "telephone_number": "708-422-2885",
            "fax_number": "708-422-7161"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GLEAVES",
        "first_name": "NANCY",
        "middle_name": "L",
        "name_prefix": "Ms.",
        "credential": "MA, LCPC, NCAC II",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-08-29",
        "last_updated": "2025-05-27",
        "certification_date": "2025-05-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "IL",
            "license": "10523",
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "IL",
            "license": "180000863",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Evergreen Park, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 27, 2025; 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.