Individual provider Active NPI

Shezelle McCaskill, LCPC

  • Professional Counselor
  • Chicago, IL
National Provider Identifier
1205495355
Registry record updated Nov 7, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
180.014105 Issued in IL
Practice address
111 W Jackson Blvd Ste 1700
Chicago, IL 60604-3597
Phone
(773) 263-7611
NPI assigned
Jun 12, 2019
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 7, 2023

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 180.014105 IL Primary

Addresses

Primary practice location

111 W Jackson Blvd Ste 1700
Chicago, IL 60604-3597

Mailing address

255 W 114TH St
Chicago, IL 60628-4159
Phone (773) 263-7611

Other practice location 1

950 E 132nd Pl
Chicago, IL 60827-1457
Phone (312) 343-6669

Other practice location 2

255 W 114th St
Chicago, IL 60628-4159
Phone (773) 263-7611

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

State licenses

LicenseStateTypeSpecialty
180.014105ILMDProfessional Counselor

NPI Registry JSON

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

{
    "created_epoch": "1560297600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1699315200000",
    "number": "1205495355",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "255 W 114TH ST",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606284159",
            "telephone_number": "773-263-7611"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "111 W JACKSON BLVD STE 1700",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606043597",
            "telephone_number": "773-263-7611"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "950 E 132nd Pl",
            "address_purpose": "LOCATION",
            "city": "Chicago",
            "state": "IL",
            "postal_code": "608271457",
            "country_code": "US",
            "telephone_number": "312-343-6669",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "255 W 114th St",
            "address_purpose": "LOCATION",
            "city": "Chicago",
            "state": "IL",
            "postal_code": "606284159",
            "country_code": "US",
            "telephone_number": "773-263-7611",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MCCASKILL",
        "first_name": "SHEZELLE",
        "credential": "LCPC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-06-12",
        "last_updated": "2023-11-07",
        "certification_date": "2023-11-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "IL",
            "license": "180.014105",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chicago, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 7, 2023; 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.