Individual provider Active NPI

Vanessa Mae Wolters

  • Professional Counselor
  • Melrose Park, IL
National Provider Identifier
1255771127
Registry record updated May 13, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
180010944 Issued in IL
Practice address
1414 Main St
Melrose Park, IL 60160-3902
Phone
(708) 681-0073
NPI assigned
Jun 25, 2013
Last updated
May 13, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 13, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Professional Counselor 101YP2500X 180010944 IL Primary
Mental Health Counselor 101YM0800X

Addresses

Primary practice location

1414 Main St
Melrose Park, IL 60160-3902

Mailing address

2100 Hassell Rd Apt 301
Hoffman Estates, IL 60169-2242
Phone (269) 363-5081

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
I20231221002637 IL Practitioner - Mental Health Counselor 7810347572 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
The Josselyn Center NFPGroup PAC ID 0840289740, 86 clinicians

Practice addresses (Care Compare)

415 Washington St
Waukegan, IL 60085-5564
Phone 8474415600136

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
The Josselyn Center NFP CurrentSince Jan 1, 2024 Accepting new patients
The Josselyn Center NFP CurrentSince Jan 1, 2024 Accepting new patients
The Josselyn Center NFP Past Accepting new patients

Locations

1135 Skokie Blvd
Northbrook, IL 60062
Phone (224) 505-5665

405 Central Ave
Northfield, IL 60093
Phone (847) 441-5603

415 Washington St
Waukegan, IL 60085
Phone (224) 480-4498

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1372118400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1715558400000",
    "number": "1255771127",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2100 HASSELL RD APT 301",
            "city": "HOFFMAN ESTATES",
            "state": "IL",
            "postal_code": "601692242",
            "telephone_number": "269-363-5081"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1414 MAIN ST",
            "city": "MELROSE PARK",
            "state": "IL",
            "postal_code": "601603902",
            "telephone_number": "708-681-0073"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WOLTERS",
        "first_name": "VANESSA",
        "middle_name": "MAE",
        "name_prefix": "Ms.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-06-25",
        "last_updated": "2024-05-13",
        "certification_date": "2024-05-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "IL",
            "license": "180010944",
            "primary": true
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Melrose Park, IL

Sources for this page

Verify at the official NPI Registry.