Individual provider Active NPI

Terese Ann Daly

  • Counselor
  • Chicago, IL
National Provider Identifier
1235973876
Registry record updated Jun 19, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
CounselorTaxonomy code 101Y00000X
License
178.019906 Issued in IL
Practice address
1448 N Milwaukee Ave Ste 201
Chicago, IL 60622-6412
Phone
(312) 476-9064
Fax
(312) 900-8230
NPI assigned
Jun 19, 2024
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 19, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Counselor 101Y00000X 178.019906 IL Primary

Addresses

Primary practice location

1448 N Milwaukee Ave Ste 201
Chicago, IL 60622-6412

Mailing address

PO Box 752123
Houston, TX 77275-2123
Phone (312) 476-9064

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
I20241113002844 IL Practitioner - Mental Health Counselor 7719411792 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
178.019906ILMDCounselor

Practice roles

OrganizationSpecialtyStatusNew patients
Willis Healthcare Inc CurrentSince Jun 23, 2024 Accepting new patients
Clarity Clinic PLLC Counselor CurrentSince Oct 27, 2024 Accepting new patients

Locations

1 E Superior St
Ste 306
Chicago, IL 60611
Phone (312) 754-9404

1448 N Milwaukee Ave
Ste 201
Chicago, IL 60622
Phone (630) 481-6463

Organizations & group practices 2

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": "1718755200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1718755200000",
    "number": "1235973876",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 752123",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "772752123",
            "telephone_number": "312-476-9064",
            "fax_number": "312-900-8230"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1448 N MILWAUKEE AVE STE 201",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606226412",
            "telephone_number": "312-476-9064",
            "fax_number": "312-900-8230"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DALY",
        "first_name": "TERESE",
        "middle_name": "ANN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2024-06-19",
        "last_updated": "2024-06-19",
        "certification_date": "2024-06-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": "IL",
            "license": "178.019906",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chicago, IL

Sources for this page

Verify at the official NPI Registry.