Sharice Ellenwood

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

Practice address

1087 N Village Dr
Round Lake Beach, IL 60073

Phone

(224) 634-1558

NPI assigned

Oct 18, 2020

Last updated

Oct 18, 2020By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

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

Specialty

Mental Health Counselor

Education

Other, 2019

Medicare assignment

May accept Medicare assignment

Group practices

Affective Counseling IncGroup PAC ID 5991158347, 7 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

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.

• Affective Counseling Inc

  • Professional Counselor
  • Barrington, IL
  • NPI 1811400187
  Medicare reassignment Care Compare group NPD

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1602979200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1602979200000",
    "number": "1225637614",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1087 N VILLAGE DR",
            "city": "ROUND LAKE BEACH",
            "state": "IL",
            "postal_code": "600732493"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1087 N VILLAGE DR",
            "city": "ROUND LAKE BEACH",
            "state": "IL",
            "postal_code": "60073",
            "telephone_number": "224-634-1558"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ELLENWOOD",
        "first_name": "SHARICE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-10-18",
        "last_updated": "2020-10-18",
        "certification_date": "2020-10-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Henry Oa Darko
• Renita Dercel Davis, MSW, MED
• Dental Professionals of Illinois, PC (Dental Care of Round Lake Beach)
• DM Family Dentistry Inc
• Dr. Dans Chiropractic Services
• Rebecca Ellis, DPT
• Ermil Wagner, D.O. P.C.
• Marlene A Espinosa
• Family Medicine Specialists of Round Lake Incorporated S C
• Jennifer Farinosi, RDH

• Professional Counselor in Round Lake Beach, IL
• Providers in Round Lake Beach, IL by specialty
• Professional Counselor in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 18, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.