Individual provider Active NPI

Haniyyah Taufique, M.S., LCPC, NCC

  • Professional Counselor
  • Northbrook, IL
National Provider Identifier
1194194332
Registry record updated Oct 20, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
180.012005 Issued in IL
Practice address
60 Revere Dr Ste 100
Northbrook, IL 60062-1590
Phone
(678) 464-1711
NPI assigned
Sep 17, 2015
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 20, 2020

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X APC005092 GA
Mental Health Counselor 101YM0800X 178.012927 IL
Mental Health Counselor 101YM0800X 180.012005 IL
Professional Counselor 101YP2500X 180.012005 IL Primary

Addresses

Primary practice location

60 Revere Dr Ste 100
Northbrook, IL 60062-1590

Mailing address

4957 Oakton Street # 255
Skokie, IL 60077-2903
Phone (872) 240-4265

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
Credentials
Master of Science

State licenses

LicenseStateTypeSpecialty
APC005092GAMDMental Health Counselor
178.012927ILMDMental Health Counselor
180.012005ILMDMental Health Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Beyond Anxiety Counseling, LLC Professional CurrentSince Aug 30, 2020 Accepting new patients

Locations

4957 Oakton St
Skokie, IL 60077
Phone (773) 308-8934

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": "1442448000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1603152000000",
    "number": "1194194332",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4957 OAKTON STREET # 255",
            "city": "SKOKIE",
            "state": "IL",
            "postal_code": "600772903",
            "telephone_number": "872-240-4265"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "60 REVERE DR STE 100",
            "city": "NORTHBROOK",
            "state": "IL",
            "postal_code": "600621590",
            "telephone_number": "678-464-1711"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TAUFIQUE",
        "first_name": "HANIYYAH",
        "credential": "M.S., LCPC, NCC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-09-17",
        "last_updated": "2020-10-20",
        "certification_date": "2020-10-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "GA",
            "license": "APC005092",
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "IL",
            "license": "178.012927",
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "IL",
            "license": "180.012005",
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "IL",
            "license": "180.012005",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Northbrook, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 20, 2020; 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.