Individual provider Active NPI

Christina K. Nolan, ED.D., NCC, LCPC

  • Professional Counselor
  • Palos Heights, IL
National Provider Identifier
1245572924
Registry record updated Mar 20, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
180.006554 Issued in IL
Practice address
11800 S 75TH Ave
Palos Heights, IL 60463-1033
Phone
(708) 671-8440
NPI assigned
Mar 20, 2013
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 20, 2013

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 180.006554 IL Primary

Addresses

Primary practice location

11800 S 75TH Ave
Palos Heights, IL 60463-1033

Mailing address

4 Old Tamarack LN
Orland Park, IL 60462-1977
Phone (708) 829-7255

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
I20240403002326 IL Practitioner - Mental Health Counselor 0941648471 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
180.006554ILMDProfessional Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Mira Neuro Behavioral Health Care, LLC CurrentSince Jan 14, 2024 Accepting new patients
Miracare Neuro Behavioral Health, PC CurrentSince Jan 14, 2024 Accepting new patients

Locations

11800 S 75th Ave
Fl 3
Palos Heights, IL 60463
Phone (708) 448-3300

11800 S 75th Ave
Ste 300
Palos Heights, IL 60463
Phone (708) 671-8440

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": "1363737600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1363737600000",
    "number": "1245572924",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4 OLD TAMARACK LN",
            "city": "ORLAND PARK",
            "state": "IL",
            "postal_code": "604621977",
            "telephone_number": "708-829-7255"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11800 S 75TH AVE",
            "city": "PALOS HEIGHTS",
            "state": "IL",
            "postal_code": "604631033",
            "telephone_number": "708-671-8440"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NOLAN",
        "first_name": "CHRISTINA",
        "middle_name": "K.",
        "name_prefix": "Dr.",
        "credential": "ED.D., NCC, LCPC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-03-20",
        "last_updated": "2013-03-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "IL",
            "license": "180.006554",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Palos Heights, IL

Sources for this page

Verify at the official NPI Registry.