Individual provider Active NPI

Alicia Jocelyn Simmons, LCPC

  • Professional Counselor
  • Matteson, IL
National Provider Identifier
1205107638
Registry record updated Sep 9, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
180.013234 Issued in IL
Practice address
4331 Lincoln Hwy
Matteson, IL 60443-2404
Phone
(708) 748-1951
Fax
(708) 748-1962
NPI assigned
Jan 17, 2012
Last updated
Sep 9, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 9, 2025

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 180.013234 IL Primary

Addresses

Primary practice location

4331 Lincoln Hwy
Matteson, IL 60443-2404

Mailing address

4331 Lincoln Hwy
Matteson, IL 60443-2404
Phone (708) 748-1951

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL, IN2 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

Enrollment IDStateProvider typePAC IDDetails
I20240930003335 IL Practitioner - Mental Health Counselor 8820529902 Reassigns benefits to 1 organization
I20241220000273 IN Practitioner - Mental Health Counselor 8820529902 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
180.013234ILMDProfessional Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Grow Healthcare Group PA Mental Health CurrentSince Aug 29, 2024 Accepting new patients

Locations

66 W Flagler St
Ste 900
Miami, FL 33130
Phone (786) 244-7711

605 N Michigan Ave
Fl 4
Chicago, IL 60611
Phone (773) 232-5338

9465 Counselors Row
Ste 200
Indianapolis, IN 46240
Phone (463) 220-4646

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1326758400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1757376000000",
    "number": "1205107638",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4331 LINCOLN HWY",
            "city": "MATTESON",
            "state": "IL",
            "postal_code": "604432404",
            "telephone_number": "708-748-1951",
            "fax_number": "708-748-1962"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4331 LINCOLN HWY",
            "city": "MATTESON",
            "state": "IL",
            "postal_code": "604432404",
            "telephone_number": "708-748-1951",
            "fax_number": "708-748-1962"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SIMMONS",
        "first_name": "ALICIA",
        "middle_name": "JOCELYN",
        "credential": "LCPC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-01-17",
        "last_updated": "2025-09-09",
        "certification_date": "2025-09-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "IL",
            "license": "180.013234",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Matteson, IL

Sources for this page

Verify at the official NPI Registry.