Active NPI
Melody Charles Van Der Werff, LCPC
- Professional Counselor
- Evanston, IL
National Provider Identifier
1184803595
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Professional Counselor
- License
- 180006656
- Practice address
- 1033 University Place
Suite 300
Evanston, IL 60201 - Phone
- (847) 492-1938
- Fax
- (847) 492-5801
- NPI assigned
- Nov 1, 2007
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Professional Counselor | 101YP2500X | 180006656 | IL | Primary |
Addresses
Primary practice location
1033 University Place
Suite 300
Evanston, IL 60201
Mailing address
1033 University PL
Suite 300
Evanston, IL 60201-3196
Phone (847) 492-1938
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)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 180006656 | IL | MD | Professional Counselor |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Springtree Counseling, P.C. | Professional | Past | Accepting new patients |
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": "1193875200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1242345600000",
"number": "1184803595",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1033 UNIVERSITY PL",
"address_2": "SUITE 300",
"city": "EVANSTON",
"state": "IL",
"postal_code": "602013196",
"telephone_number": "847-492-1938",
"fax_number": "847-492-5801"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1033 UNIVERSITY PLACE",
"address_2": "SUITE 300",
"city": "EVANSTON",
"state": "IL",
"postal_code": "60201",
"telephone_number": "847-492-1938",
"fax_number": "847-492-5801"
}
],
"practiceLocations": [],
"basic": {
"last_name": "VAN DER WERFF",
"first_name": "MELODY",
"middle_name": "CHARLES",
"credential": "LCPC",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-11-01",
"last_updated": "2009-05-15",
"status": "A"
},
"taxonomies": [
{
"code": "101YP2500X",
"taxonomy_group": "",
"desc": "Counselor, Professional",
"state": "IL",
"license": "180006656",
"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 May 15, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.