Individual provider Active NPI

Celinda Smith, LCPC

  • Mental Health Counselor
  • Machesney Park, IL
National Provider Identifier
1184387102
Registry record updated Feb 18, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
180.014800 Issued in IL
Practice address
9950 N Alpine Rd Ste 103
Machesney Park, IL 61115-8362
Phone
(815) 200-6444
Fax
(815) 201-1702
NPI assigned
Oct 17, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 18, 2025

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 180.014800 IL Primary

Addresses

Primary practice location

9950 N Alpine Rd Ste 103
Machesney Park, IL 61115-8362

Mailing address

4751 Minns Dr
Machesney Park, IL 61115-1930
Phone (815) 621-1844

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL
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 1

Enrollment IDStateProvider typePAC IDDetails
I20240115001361 IL Practitioner - Mental Health Counselor 8527410695 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Alternative Wellness Therapies PLLCGroup PAC ID 8628505823, 3 clinicians

Practice addresses (Care Compare)

9950 N Alpine Rd
Suite 103
Machesney Park, IL 61115-8362
Phone (815) 200-6444

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
180.014800ILMDMental Health Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Alternative Wellness Therapies PLLC Professional CurrentSince Jan 13, 2025 Accepting new patients

Locations

9950 N Alpine Rd
Machesney Park, IL 61115

9950 N Alpine Rd
Ste 103
Machesney Park, IL 61115
Phone (815) 200-6444

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": "1634428800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1739836800000",
    "number": "1184387102",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4751 MINNS DR",
            "city": "MACHESNEY PARK",
            "state": "IL",
            "postal_code": "611151930",
            "telephone_number": "815-621-1844"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9950 N ALPINE RD STE 103",
            "city": "MACHESNEY PARK",
            "state": "IL",
            "postal_code": "611158362",
            "telephone_number": "815-200-6444",
            "fax_number": "815-201-1702"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMITH",
        "first_name": "CELINDA",
        "credential": "LCPC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-10-17",
        "last_updated": "2025-02-18",
        "certification_date": "2025-02-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "IL",
            "license": "180.014800",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Machesney Park, IL

Sources for this page

Verify at the official NPI Registry.