Individual provider Active NPI

Ericka Marie Ortiz, LCPC

  • Mental Health Counselor
  • Hoffman Estates, IL
National Provider Identifier
1124358338
Registry record updated Oct 26, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
180-005687 Issued in IL
Practice address
1786 Moon Lake Blvd
Suite 104
Hoffman Estates, IL 60169-5029
Phone
(847) 755-8090
Fax
(847) 843-7393
NPI assigned
Jan 11, 2010
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 26, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X 180-005687 IL Primary

Addresses

Primary practice location

1786 Moon Lake Blvd
Suite 104
Hoffman Estates, IL 60169-5029

Mailing address

1786 Moon Lake Blvd
Suite 104
Hoffman Estates, IL 60169-5029
Phone (847) 755-8090

Other names 1

  • Ericka Marie Johann Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20231228003171 IL Practitioner - Mental Health Counselor 3375993660 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 2000
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Alexian Brothers Behavioral Health Hospital 55 clinicians

Practice addresses (Care Compare)

1650 Moon Lake Blvd
Hoffman Estates, IL 60169-1010
Phone (847) 755-8090

1786 Moon Lake Blvd
Suite 104
Hoffman Estates, IL 60169-1016
Phone (847) 755-8090

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
180-005687ILMDMental Health Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Alexian Brothers Behavioral Health Hospital Mental Health CurrentSince Jan 1, 2024 Accepting new patients

Locations

1786 Moon Lake Blvd
Ste 104
Hoffman Estates, IL 60169

1650 Moon Lake Blvd
Hoffman Estates, IL 60169
Phone (800) 432-5005

Interoperability endpoints

  • Direct secure messaging: ericka.ortiz.1@15182.direct.athenahealth.com

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1263168000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1288051200000",
    "number": "1124358338",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1786 MOON LAKE BLVD",
            "address_2": "SUITE 104",
            "city": "HOFFMAN ESTATES",
            "state": "IL",
            "postal_code": "601695029",
            "telephone_number": "847-755-8090",
            "fax_number": "847-843-7393"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1786 MOON LAKE BLVD",
            "address_2": "SUITE 104",
            "city": "HOFFMAN ESTATES",
            "state": "IL",
            "postal_code": "601695029",
            "telephone_number": "847-755-8090",
            "fax_number": "847-843-7393"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ORTIZ",
        "first_name": "ERICKA",
        "middle_name": "MARIE",
        "credential": "LCPC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-01-11",
        "last_updated": "2010-10-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "IL",
            "license": "180-005687",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ERICKA",
            "last_name": "JOHANN",
            "middle_name": "MARIE",
            "credential": "LCPC",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Hoffman Estates, IL

Sources for this page

Verify at the official NPI Registry.