Individual provider Active NPI

Tierney Puig, LPC

  • Mental Health Counselor
  • Northbrook, IL
National Provider Identifier
1205654274
Registry record updated Sep 30, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
178.020625 Issued in IL
Practice address
3000 Dundee Rd Ste 418
Northbrook, IL 60062-2436
Phone
(847) 306-6477
NPI assigned
Sep 30, 2024
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 30, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X 178.020625 IL Primary

Addresses

Primary practice location

3000 Dundee Rd Ste 418
Northbrook, IL 60062-2436

Mailing address

1636 Ashland Ave Unit 407
Des Plaines, IL 60016-7724
Phone (846) 363-0962

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
178.020625ILMDMental Health Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Cutting Edge Counseling of the North Shore, NFP Mental Health CurrentSince Oct 6, 2024 Accepting new patients

Locations

3000 Dundee Rd
Ste 418
Northbrook, IL 60062
Phone (847) 220-8838

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": "1727654400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1727654400000",
    "number": "1205654274",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1636 ASHLAND AVE UNIT 407",
            "city": "DES PLAINES",
            "state": "IL",
            "postal_code": "600167724",
            "telephone_number": "846-363-0962"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3000 DUNDEE RD STE 418",
            "city": "NORTHBROOK",
            "state": "IL",
            "postal_code": "600622436",
            "telephone_number": "847-306-6477"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PUIG",
        "first_name": "TIERNEY",
        "credential": "LPC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-09-30",
        "last_updated": "2024-09-30",
        "certification_date": "2024-09-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "IL",
            "license": "178.020625",
            "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 Sep 30, 2024; 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.