Active NPI
Latrenda Carlette Brown
- Addiction (Substance Use Disorder) Counselor
- Hanover Park, IL
National Provider Identifier
1245900299
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Addiction (Substance Use Disorder) Counselor
- License
- 30105
- Practice address
- 2035 Cherry Ave
Hanover Park, IL 60133-3572 - Phone
- (847) 893-6663
- NPI assigned
- Sep 20, 2021
- 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 |
|---|---|---|---|---|
| Addiction (Substance Use Disorder) Counselor | 101YA0400X | 30105 | IL | Primary |
Addresses
Primary practice location
2035 Cherry Ave
Hanover Park, IL 60133-3572
Mailing address
2035 Cherry Ave
Hanover Park, IL 60133-3572
Phone (847) 893-6663
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 |
|---|---|---|---|
| 30105 | IL | MD | Addiction (Substance Use Disorder) Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1632096000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1632096000000",
"number": "1245900299",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2035 CHERRY AVE",
"city": "HANOVER PARK",
"state": "IL",
"postal_code": "601333572",
"telephone_number": "847-893-6663"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2035 CHERRY AVE",
"city": "HANOVER PARK",
"state": "IL",
"postal_code": "601333572",
"telephone_number": "847-893-6663"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BROWN",
"first_name": "LATRENDA",
"middle_name": "CARLETTE",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2021-09-20",
"last_updated": "2021-09-20",
"certification_date": "2021-09-20",
"status": "A"
},
"taxonomies": [
{
"code": "101YA0400X",
"taxonomy_group": "",
"desc": "Counselor, Addiction (Substance Use Disorder)",
"state": "IL",
"license": "30105",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Hanover Park, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 20, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.