Individual provider Active NPI

Kristin Marie Peters, LCPC, LPC, SAC

  • Professional Counselor
  • Chicago, IL
National Provider Identifier
1215351747
Registry record updated Apr 29, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
180.014620 Issued in IL
Practice address
5536 S Everett Ave
Chicago, IL 60637-1902
Phone
(773) 643-6259
NPI assigned
Feb 4, 2014
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 29, 2025

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Professional Counselor 101YP2500X 6336-125 WI
Professional Counselor 101YP2500X 180.014620 IL Primary
Counselor 101Y00000X 16331 WI
Addiction (Substance Use Disorder) Counselor 101YA0400X 15975-131 WI

Addresses

Primary practice location

5536 S Everett Ave
Chicago, IL 60637-1902

Mailing address

PO Box 15219
Chicago, IL 60615-5140
Phone (773) 643-6259

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL
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 1

Enrollment IDStateProvider typePAC IDDetails
I20250728002665 IL Practitioner - Mental Health Counselor 2365959046 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

5536 S Everett Ave
Chicago, IL 60637-1902
Phone (773) 643-6259

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
16331WIMDCounselor
15975-131WIMDAddiction (Substance Use Disorder) Counselor
180.014620ILMDProfessional Counselor
6336-125WIMDProfessional Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
United States Conference of Catholic Bishops - Claret Center Inc. CurrentSince Jul 17, 2025 Accepting new patients

Locations

5536 S Everett Ave
Chicago, IL 60637
Phone (773) 270-1985

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": "1391472000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1745884800000",
    "number": "1215351747",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 15219",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606155140",
            "telephone_number": "773-643-6259"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5536 S EVERETT AVE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606371902",
            "telephone_number": "773-643-6259"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PETERS",
        "first_name": "KRISTIN",
        "middle_name": "MARIE",
        "name_prefix": "Ms.",
        "credential": "LCPC, LPC, SAC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-02-04",
        "last_updated": "2025-04-29",
        "certification_date": "2025-04-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "WI",
            "license": "6336-125",
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "IL",
            "license": "180.014620",
            "primary": true
        },
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": "WI",
            "license": "16331",
            "primary": false
        },
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "WI",
            "license": "15975-131",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chicago, IL

Sources for this page

Verify at the official NPI Registry.