Allison Faye Wollert, LPC

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

178.014391 Issued in IL

Practice address

1641 N Milwaukee Ave Ste 7
Libertyville, IL 60048-1350

Phone

(847) 362-6919

NPI assigned

Dec 23, 2018

Last updated

Dec 23, 2018By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in IL, WI2 enrollments

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 2

Specialty

Mental Health Counselor

Education

Other, 2018

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Ganesha Institute of Neurology and Psychiatry SCGroup PAC ID 0042432296, 25 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: allison.wollert.1@9664.direct.athenahealth.com

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Ganesha Institute of Neurology and Psychiatry SC

  dba A Ray of Hope: The Great Lakes Institute of Neurology and Psychiatry

  • Neurology Physician
  • Libertyville, IL
  • NPI 1629478599

  WI

  Medicare reassignment Care Compare group NPD
• County of Lake

  dba Lake County Health Department and Community Health Center

  • Public Health or Welfare Agency
  • Waukegan, IL
  • NPI 1013920750
  Medicare reassignment NPD
• County of Lake

  dba Lake County Health Department and Community Health Center

  • Federally Qualified Health Center (FQHC)
  • Waukegan, IL
  • NPI 1376717702
  NPD
• County of Lake

  dba Lake County Health Department and Community Health Center

  • Federally Qualified Health Center (FQHC)
  • Round Lake, IL
  • NPI 1639588254
  NPD
• Ganesha Institute of Neurology and Psychiatry SC

  • Neurology Physician
  • Kenosha, WI
  • NPI 1619731320
  NPD
• The Family Stress Clinic

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Libertyville, IL
  • NPI 1669562559
  NPD (past)

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

{
    "created_epoch": "1545523200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1545523200000",
    "number": "1164994562",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "358 WOODLAND DR",
            "city": "GRAYSLAKE",
            "state": "IL",
            "postal_code": "600301450",
            "telephone_number": "224-239-0099"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1641 N MILWAUKEE AVE STE 7",
            "city": "LIBERTYVILLE",
            "state": "IL",
            "postal_code": "600481350",
            "telephone_number": "847-362-6919"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WOLLERT",
        "first_name": "ALLISON",
        "middle_name": "FAYE",
        "credential": "LPC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-12-23",
        "last_updated": "2018-12-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "IL",
            "license": "178.014391",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Wisz & Katz Enterprises PC (Libertybille Dental Associates)
• Taylor Leigh Witt, LCSW
• Barbara Wlodarczyk
• Amanda Jane Wojciechowski, M.D.
• Mark Adam Wojciechowski, D.D.S.
• Deanna Wong, FNP-C
• Sharon Wei Lu Wong, M.D.
• Sara L Wright, ATC
• Wensheng Tracy Wu
• James Wyman, DPT

• Mental Health Counselor in Libertyville, IL
• Providers in Libertyville, 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 Dec 23, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.