Johanna Tesfaye, LPC

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

Practice address

305 Quail Ridge Dr
Westmont, IL 60559-6144

Phone

(630) 580-8080

NPI assigned

Oct 13, 2022

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Practice roles

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.

• Elevate Counseling and Wellness LLC

  • Mental Health Counselor
  • Hinsdale, IL
  • NPI 1225684087
  NPD (past)

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

{
    "created_epoch": "1665619200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1665619200000",
    "number": "1154047983",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5430 S CORNELL AVE APT 201",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606155695",
            "telephone_number": "217-621-7328"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "305 QUAIL RIDGE DR",
            "city": "WESTMONT",
            "state": "IL",
            "postal_code": "605596144",
            "telephone_number": "630-580-8080"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TESFAYE",
        "first_name": "JOHANNA",
        "credential": "LPC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-10-13",
        "last_updated": "2022-10-13",
        "certification_date": "2022-10-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "IL",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "http://www.elevatecounseling.com",
            "affiliation": "Y",
            "affiliationName": "Elevate Counseling and Wellness LLC",
            "address_1": "305 Quail Ridge Dr",
            "city": "Westmont",
            "state": "IL",
            "country_code": "US",
            "postal_code": "605596144",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

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• Mental Health Counselor in Westmont, IL
• Providers in Westmont, IL by specialty
• Mental Health Counselor in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 13, 2022; 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.