Active NPI
Kari M Fitzgerald, LCPC
- Professional Counselor
- Joliet, IL
National Provider Identifier
1144810490
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Professional Counselor
- Practice address
- 3012 Haven CT
Joliet, IL 60435-2831 - Phone
- (815) 310-0351
- NPI assigned
- Jan 21, 2021
- 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 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Professional Counselor | 101YP2500X | Primary | ||
| Mental Health Counselor | 101YM0800X | 180013297 | IL |
Addresses
Primary practice location
3012 Haven CT
Joliet, IL 60435-2831
Mailing address
2364 Essington Rd # 313
Joliet, IL 60435-1664
Phone (773) 354-1970
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 180013297 | Other | IL | STATE LICENSE |
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 |
|---|---|---|---|
| 180013297 | IL | MD | Mental Health Counselor |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Birchwood Theraputic Services, LLC | Professional | Current | Accepting new patients |
Locations
2364 Essington Rd
Joliet, IL 60435
Phone (815) 546-0897
Organizations & group practices 1
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.
-
- Professional Counselor
- Joliet, IL
- NPI 1992425771
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1611187200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1704326400000",
"number": "1144810490",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2364 ESSINGTON RD # 313",
"city": "JOLIET",
"state": "IL",
"postal_code": "604351664",
"telephone_number": "773-354-1970"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3012 HAVEN CT",
"city": "JOLIET",
"state": "IL",
"postal_code": "604352831",
"telephone_number": "815-310-0351"
}
],
"practiceLocations": [],
"basic": {
"last_name": "FITZGERALD",
"first_name": "KARI",
"middle_name": "M",
"credential": "LCPC",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2021-01-21",
"last_updated": "2024-01-04",
"certification_date": "2024-01-02",
"status": "A"
},
"taxonomies": [
{
"code": "101YP2500X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Counselor, Professional",
"state": null,
"license": null,
"primary": true
},
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": "IL",
"license": "180013297",
"primary": false
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "STATE LICENSE",
"identifier": "180013297",
"state": "IL"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Joliet, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 4, 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.