Individual provider Active NPI

Shannon L Parsons, MA, LPC

  • Mental Health Counselor
  • Gurnee, IL
National Provider Identifier
1124347570
Registry record updated Feb 6, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
180.009529 Issued in IL
Practice address
4343 Old Grand Ave Ste 205
Gurnee, IL 60031-2700
Phone
(847) 416-0135
NPI assigned
May 25, 2010
Last updated
Feb 6, 2019By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 6, 2019

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X 178.006637 IL
Mental Health Counselor 101YM0800X 180.009529 IL Primary

Addresses

Primary practice location

4343 Old Grand Ave Ste 205
Gurnee, IL 60031-2700

Mailing address

4343 Old Grand Ave Ste 205
Gurnee, IL 60031-2700
Phone (847) 416-0135

Other practice location 1

2018 Dawn Ln
Zion, IL 60099-5108
Phone (847) 731-3192

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
178.006637ILMDMental Health Counselor
180.009529ILMDMental Health Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Breath of Life Christian Counseling LLC CurrentSince Aug 25, 2024 Accepting new patients
Love-Light Christian Counseling, NFP Mental Health Past Accepting new patients

Locations

495 N Il Route 21
Ste 101
Gurnee, IL 60031
Phone (847) 416-0135

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, 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": "1274745600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1549411200000",
    "number": "1124347570",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4343 OLD GRAND AVE STE 205",
            "city": "GURNEE",
            "state": "IL",
            "postal_code": "600312700",
            "telephone_number": "847-416-0135"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4343 OLD GRAND AVE STE 205",
            "city": "GURNEE",
            "state": "IL",
            "postal_code": "600312700",
            "telephone_number": "847-416-0135"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2018 Dawn Ln",
            "address_purpose": "LOCATION",
            "city": "Zion",
            "state": "IL",
            "postal_code": "600995108",
            "country_code": "US",
            "telephone_number": "847-731-3192",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PARSONS",
        "first_name": "SHANNON",
        "middle_name": "L",
        "credential": "MA, LPC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2010-05-25",
        "last_updated": "2019-02-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "IL",
            "license": "178.006637",
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "IL",
            "license": "180.009529",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Gurnee, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 6, 2019; 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.