Individual provider Active NPI

Kristen Simons, LCPC

  • Mental Health Counselor
  • Evanston, IL
National Provider Identifier
1154786978
Registry record updated Aug 12, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
180011467 Issued in IL
Practice address
2916 Central St Ste 2
Evanston, IL 60201-1212
Phone
(224) 307-4736
NPI assigned
Dec 21, 2015
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 12, 2019

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 180011467 IL Primary

Addresses

Primary practice location

2916 Central St Ste 2
Evanston, IL 60201-1212

Mailing address

2916 Central St Ste 2
Evanston, IL 60201-1212
Phone (224) 307-4736

Other practice location 1

17840 Cumberland Rd
Noblesville, IN 46060-5409
Phone (317) 574-1254

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
180011467ILMDMental Health Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Embodied Healing Counseling and Yoga Mental Health CurrentSince Nov 18, 2025 Accepting new patients

Locations

832 Dempster St
Evanston, IL 60202
Phone (224) 307-4736

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.

NPI Registry JSON

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

{
    "created_epoch": "1450656000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1565568000000",
    "number": "1154786978",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2916 CENTRAL ST STE 2",
            "city": "EVANSTON",
            "state": "IL",
            "postal_code": "602011212",
            "telephone_number": "224-307-4736"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2916 CENTRAL ST STE 2",
            "city": "EVANSTON",
            "state": "IL",
            "postal_code": "602011212",
            "telephone_number": "224-307-4736"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "17840 Cumberland Rd",
            "address_purpose": "LOCATION",
            "city": "Noblesville",
            "state": "IN",
            "postal_code": "460605409",
            "country_code": "US",
            "telephone_number": "317-574-1254",
            "fax_number": "317-674-0060",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SIMONS",
        "first_name": "KRISTEN",
        "credential": "LCPC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2015-12-21",
        "last_updated": "2019-08-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "IL",
            "license": "180011467",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Evanston, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 12, 2019; 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.