Individual provider Active NPI

Kassie Danielle Straker, LCPC, ATR-BC, CADC

  • Professional Counselor
  • Chicago, IL
National Provider Identifier
1215608591
Registry record updated Sep 25, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
180010996 Issued in IL
Practice address
980 N Michigan Ave Ste 1400
Chicago, IL 60611-7500
Phone
(773) 217-9511
NPI assigned
Sep 25, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 25, 2021

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 180010996 IL Primary

Addresses

Primary practice location

980 N Michigan Ave Ste 1400
Chicago, IL 60611-7500

Mailing address

4745 N Hermitage Ave Apt 1F
Chicago, IL 60640-4438
Phone (515) 419-5390

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
180010996ILMDProfessional Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Creative Alchemy Counseling Current Accepting new patients

Locations

5215 N Ravenswood Ave
Ste 312
Chicago, IL 60640
Phone (312) 286-5039

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": "1632528000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1632528000000",
    "number": "1215608591",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4745 N HERMITAGE AVE APT 1F",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606404438",
            "telephone_number": "515-419-5390"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "980 N MICHIGAN AVE STE 1400",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606117500",
            "telephone_number": "773-217-9511"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STRAKER",
        "first_name": "KASSIE",
        "middle_name": "DANIELLE",
        "credential": "LCPC, ATR-BC, CADC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-09-25",
        "last_updated": "2021-09-25",
        "certification_date": "2021-09-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "IL",
            "license": "180010996",
            "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 Sep 25, 2021; 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.