Taylor Kaether, MS, LCPC
Individual provider Active NPI Mental Health Counselor · Fox Lake, IL
NPI 1235722307 · NPPES record last updated Dec 22, 2023
Key facts
- NPI
- 1235722307
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Mental Health Counselor 101YM0800X
- License
- 180015718 (IL)
- Practice address
- 34 W Grand Ave Ste 101
Fox Lake, IL 60020-1224 - Phone
- (847) 322-2975
- NPI assigned
- Feb 18, 2021
- Sex
- Female
- Sole proprietor
- Yes
Organizations & group practices 2
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in IL
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: No · Power mobility devices: No · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20240919000949 | IL | Practitioner - Mental Health Counselor | 6305386723 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Master of Science
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 180015718 | IL | MD | Mental Health Counselor |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Sheffer Psychological Services, PLLC | Current |
Accepting new patients |
Locations
34 W Grand Ave
Ste 101
Fox Lake, IL 60020
Phone (847) 322-3975
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | 180015718 | IL | Yes |
Addresses
Primary practice location
34 W Grand Ave Ste 101
Fox Lake, IL 60020-1224
Mailing address
12663 W Bonnie Brook LN
Beach Park, IL 60087-2648
NPI Registry JSON
{
"created_epoch": "1613606400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1703203200000",
"number": "1235722307",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "12663 W BONNIE BROOK LN",
"city": "BEACH PARK",
"state": "IL",
"postal_code": "600872648"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "34 W GRAND AVE STE 101",
"city": "FOX LAKE",
"state": "IL",
"postal_code": "600201224",
"telephone_number": "847-322-2975"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KAETHER",
"first_name": "TAYLOR",
"credential": "MS, LCPC",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2021-02-18",
"last_updated": "2023-12-22",
"certification_date": "2023-12-22",
"status": "A"
},
"taxonomies": [
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": "IL",
"license": "180015718",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Fox Lake, IL
- Carlton Bruce Hagstrom
- Mackenzie Hansen
- Healthcare Associates
- Patryk Janowski
- Nicholas Kaczkowski
- Kristine S Kahn
- Jorid Keri
- Allison Kriegler
- Lake Optical, Inc.
- Lakes Health and Wellness LLC
All providers in Fox Lake, IL · Mental Health Counselor in Illinois
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Dec 22, 2023. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.