Active NPI
Sarah Clell Prendergast, LCPC
- Professional Counselor
- Westchester, IL
National Provider Identifier
1225206097
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Professional Counselor
- License
- 180009848
- Practice address
- 2225 Enterprise Dr
Suite 2515
Westchester, IL 60154-5814 - Phone
- (708) 223-8405
- Fax
- (708) 223-0197
- NPI assigned
- Feb 14, 2008
- Last updated
- Nov 12, 2015
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Professional Counselor | 101YP2500X | 180009848 | IL | Primary |
| Professional Counselor | 101YP2500X | 178010166 | IL |
Addresses
Primary practice location
2225 Enterprise Dr
Suite 2515
Westchester, IL 60154-5814
Mailing address
2225 Enterprise Dr
Suite 2515
Westchester, IL 60154-5814
Phone (708) 223-8405
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
| License | State | Type | Specialty |
|---|---|---|---|
| 178010166 | IL | MD | Professional Counselor |
| 180009848 | IL | MD | Professional Counselor |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Diverse Legacy Incorporated | Past | 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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1202947200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1447286400000",
"number": "1225206097",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2225 ENTERPRISE DR",
"address_2": "SUITE 2515",
"city": "WESTCHESTER",
"state": "IL",
"postal_code": "601545814",
"telephone_number": "708-223-8405",
"fax_number": "708-223-0197"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2225 ENTERPRISE DR",
"address_2": "SUITE 2515",
"city": "WESTCHESTER",
"state": "IL",
"postal_code": "601545814",
"telephone_number": "708-223-8405",
"fax_number": "708-223-0197"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PRENDERGAST",
"first_name": "SARAH",
"middle_name": "CLELL",
"name_prefix": "Mrs.",
"credential": "LCPC",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2008-02-14",
"last_updated": "2015-11-12",
"status": "A"
},
"taxonomies": [
{
"code": "101YP2500X",
"taxonomy_group": "",
"desc": "Counselor, Professional",
"state": "IL",
"license": "180009848",
"primary": true
},
{
"code": "101YP2500X",
"taxonomy_group": "",
"desc": "Counselor, Professional",
"state": "IL",
"license": "178010166",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Westchester, IL
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- Jennifer Prim, MS, CCC-SLP
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 12, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.