Active NPI
Kimberly Vachon, LCPC
- Professional Counselor
- Chicago, IL
National Provider Identifier
1245779172
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Professional Counselor
- License
- 180.010056
- Practice address
- 3234 W Fullerton Ave
Chicago, IL 60647-2594 - Phone
- (773) 466-9882
- NPI assigned
- Feb 12, 2017
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Professional Counselor | 101YP2500X | 180.010056 | IL | Primary |
Addresses
Primary practice location
3234 W Fullerton Ave
Chicago, IL 60647-2594
Mailing address
3234 W Fullerton Ave
Chicago, IL 60647-2594
Phone (773) 466-9882
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 180.010056 | IL | MD | Professional Counselor |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Five Point Holistic Health | Professional | Past | Accepting new patients |
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 and National Provider Directory roles.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1486857600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1486857600000",
"number": "1245779172",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3234 W FULLERTON AVE",
"city": "CHICAGO",
"state": "IL",
"postal_code": "606472594",
"telephone_number": "773-466-9882"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3234 W FULLERTON AVE",
"city": "CHICAGO",
"state": "IL",
"postal_code": "606472594",
"telephone_number": "773-466-9882"
}
],
"practiceLocations": [],
"basic": {
"last_name": "VACHON",
"first_name": "KIMBERLY",
"credential": "LCPC",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2017-02-12",
"last_updated": "2017-02-12",
"status": "A"
},
"taxonomies": [
{
"code": "101YP2500X",
"taxonomy_group": "",
"desc": "Counselor, Professional",
"state": "IL",
"license": "180.010056",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Chicago, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 12, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.