Individual provider Active NPI

Stephanie Kilper, LCPC

  • Professional Counselor
  • Chicago, IL
National Provider Identifier
1205582095
Registry record updated Feb 12, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
180015157 Issued in IL
Practice address
1802 W Berteau Ave Ste 205
Chicago, IL 60613-6182
Phone
(708) 580-8848
NPI assigned
Mar 1, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 12, 2024

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Professional Counselor 101YP2500X 178016691 IL
Dance Therapist 225600000X BC-DMT-1408 IL
Professional Counselor 101YP2500X 180015157 IL Primary

Addresses

Primary practice location

1802 W Berteau Ave Ste 205
Chicago, IL 60613-6182

Mailing address

1802 W Berteau Ave Ste 205
Chicago, IL 60613-6182
Phone (708) 580-8848

Other practice location 1

24W788 75th St
Naperville, IL 60565-1684
Phone (312) 543-2133

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Opted out of Medicare
Yes, effective Feb 4, 2024 through Feb 4, 2028

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
178016691ILMDProfessional Counselor
180015157ILMDProfessional Counselor
BC-DMT-1408ILMDDance Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Mind Body Connections PLLC Professional PastSince Feb 18, 2024 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": "1646092800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1707696000000",
    "number": "1205582095",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1802 W BERTEAU AVE STE 205",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606136182",
            "telephone_number": "708-580-8848"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1802 W BERTEAU AVE STE 205",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606136182",
            "telephone_number": "708-580-8848"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "24W788 75th St",
            "address_purpose": "LOCATION",
            "city": "Naperville",
            "state": "IL",
            "postal_code": "605651684",
            "country_code": "US",
            "telephone_number": "312-543-2133",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KILPER",
        "first_name": "STEPHANIE",
        "credential": "LCPC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-03-01",
        "last_updated": "2024-02-12",
        "certification_date": "2024-02-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "IL",
            "license": "178016691",
            "primary": false
        },
        {
            "code": "225600000X",
            "taxonomy_group": "",
            "desc": "Dance Therapist",
            "state": "IL",
            "license": "BC-DMT-1408",
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "IL",
            "license": "180015157",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chicago, IL

Sources for this page

Verify at the official NPI Registry.