Active NPI
Nicole Marcia Danzell
- Marriage & Family Therapist
- Yorkville, IL
National Provider Identifier
1134958622
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Marriage & Family Therapist
- License
- 208.001189
- Practice address
- 465 Shadow Wood Dr
Yorkville, IL 60560-4685 - Phone
- (779) 279-2028
- NPI assigned
- Jul 31, 2024
- 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 |
|---|---|---|---|---|
| Marriage & Family Therapist | 106H00000X | 208.001189 | IL | Primary |
Addresses
Primary practice location
465 Shadow Wood Dr
Yorkville, IL 60560-4685
Mailing address
465 Shadow Wood Dr
Yorkville, IL 60560-4685
Phone (779) 279-2028
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
| License | State | Type | Specialty |
|---|---|---|---|
| 208.001189 | IL | MD | Marriage & Family Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1722384000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1723507200000",
"number": "1134958622",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "465 SHADOW WOOD DR",
"city": "YORKVILLE",
"state": "IL",
"postal_code": "605604685",
"telephone_number": "779-279-2028"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "465 SHADOW WOOD DR",
"city": "YORKVILLE",
"state": "IL",
"postal_code": "605604685",
"telephone_number": "779-279-2028"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DANZELL",
"first_name": "NICOLE",
"middle_name": "MARCIA",
"name_prefix": "Mrs.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2024-07-31",
"last_updated": "2024-08-13",
"certification_date": "2024-08-13",
"status": "A"
},
"taxonomies": [
{
"code": "106H00000X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Marriage & Family Therapist",
"state": "IL",
"license": "208.001189",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Yorkville, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 13, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.