Individual provider Active NPI

Anna L Andersen, LPC

  • Professional Counselor
  • Chicago, IL
National Provider Identifier
1154907111
Registry record updated Mar 21, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
178.013224 Issued in IL
Practice address
180 N Michigan Ave Ste 410
Chicago, IL 60601-7488
Phone
(888) 726-7170
Fax
(312) 782-8276
NPI assigned
Mar 21, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 21, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Professional Counselor 101YP2500X 178.013224 IL Primary

Addresses

Primary practice location

180 N Michigan Ave Ste 410
Chicago, IL 60601-7488

Mailing address

5716 S Kolmar Ave
Chicago, IL 60629-5310
Phone (872) 777-6185

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address aandersen@urbanbalance.com Direct Urban Balance

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
178.013224ILMDProfessional Counselor

NPI Registry JSON

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

{
    "created_epoch": "1616284800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1616284800000",
    "number": "1154907111",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5716 S KOLMAR AVE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606295310",
            "telephone_number": "872-777-6185"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "180 N MICHIGAN AVE STE 410",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606017488",
            "telephone_number": "888-726-7170",
            "fax_number": "312-782-8276"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ANDERSEN",
        "first_name": "ANNA",
        "middle_name": "L",
        "credential": "LPC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-03-21",
        "last_updated": "2021-03-21",
        "certification_date": "2021-03-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "IL",
            "license": "178.013224",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "aandersen@urbanbalance.com",
            "affiliation": "Y",
            "endpointDescription": "Email",
            "affiliationName": "Urban Balance",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "180 N Michigan Ave Ste 410",
            "city": "Chicago",
            "state": "IL",
            "country_code": "US",
            "postal_code": "606017488",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Chicago, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 21, 2021; 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.