Individual provider Active NPI

Tiffany Jeaneen Holden

  • Professional Counselor
  • Chicago, IL
National Provider Identifier
1235682485
Registry record updated Jan 6, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
180.0164528 Issued in IL
Practice address
6618 S Drexel Ave
Chicago, IL 60637-6171
Phone
(224) 322-9858
NPI assigned
Jul 24, 2016
Last updated
Jan 6, 2026By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 6, 2026

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 180.0164528 IL Primary

Addresses

Primary practice location

6618 S Drexel Ave
Chicago, IL 60637-6171

Mailing address

6618 S Drexel Ave
Chicago, IL 60637-6171

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
I20250421002400 IL Practitioner - Mental Health Counselor 1759806979 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
180.0164528ILMDProfessional Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Resk Residential Services Inc, CurrentSince Apr 17, 2025 Accepting new patients

Locations

6127 S University Ave
Ste 1250
Chicago, IL 60637
Phone (312) 721-2471

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": "1469318400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1767657600000",
    "number": "1235682485",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6618 S DREXEL AVE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606376171"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6618 S DREXEL AVE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606376171",
            "telephone_number": "224-322-9858"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HOLDEN",
        "first_name": "TIFFANY",
        "middle_name": "JEANEEN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-07-24",
        "last_updated": "2026-01-06",
        "certification_date": "2026-01-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "IL",
            "license": "180.0164528",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chicago, IL

Sources for this page

Verify at the official NPI Registry.