Individual provider Active NPI

Timothy Enarson

  • Mental Health Counselor
  • Arlington Heights, IL
National Provider Identifier
1124890033
Registry record updated Oct 24, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
178.018520 Issued in IL
Practice address
4256 N Arlington Heights Rd Ste 101
Arlington Heights, IL 60004-1399
Phone
(847) 295-1600
NPI assigned
Oct 24, 2023
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 24, 2023

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 178.018520 IL Primary

Addresses

Primary practice location

4256 N Arlington Heights Rd Ste 101
Arlington Heights, IL 60004-1399

Mailing address

1139 Darrow Ave
Evanston, IL 60202-1111
Phone (847) 565-9048

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

State licenses

LicenseStateTypeSpecialty
178.018520ILMDMental Health Counselor

NPI Registry JSON

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

{
    "created_epoch": "1698105600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1698105600000",
    "number": "1124890033",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1139 DARROW AVE",
            "city": "EVANSTON",
            "state": "IL",
            "postal_code": "602021111",
            "telephone_number": "847-565-9048"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4256 N ARLINGTON HEIGHTS RD STE 101",
            "city": "ARLINGTON HEIGHTS",
            "state": "IL",
            "postal_code": "600041399",
            "telephone_number": "847-295-1600"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ENARSON",
        "first_name": "TIMOTHY",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2023-10-24",
        "last_updated": "2023-10-24",
        "certification_date": "2023-10-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "IL",
            "license": "178.018520",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Arlington Heights, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 24, 2023; 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.