Samantha D Tyree, MA, LPC

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

178.012030 Issued in IL

Practice address

109 White LN
Apt 1
Minooka, IL 60447-9307

Phone

(815) 955-9068

NPI assigned

Jun 10, 2016

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

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

Specialty

Mental Health Counselor

Education

Other, 2014

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Alliance Counseling and Coaching of Illinois LLCGroup PAC ID 5496093213, 19 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Master of Arts

State licenses

Practice roles

Locations

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.

• Alliance Counseling & Coaching of Illinois, LLC

  • Professional Counselor
  • Channahon, IL
  • NPI 1063867257
  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1465516800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1465516800000",
    "number": "1255780102",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "109 WHITE LN",
            "address_2": "APT 1",
            "city": "MINOOKA",
            "state": "IL",
            "postal_code": "604479307",
            "telephone_number": "815-955-9068"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "109 WHITE LN",
            "address_2": "APT 1",
            "city": "MINOOKA",
            "state": "IL",
            "postal_code": "604479307",
            "telephone_number": "815-955-9068"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TYREE",
        "first_name": "SAMANTHA",
        "middle_name": "D",
        "name_prefix": "Ms.",
        "credential": "MA, LPC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-06-10",
        "last_updated": "2016-06-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "IL",
            "license": "178.012030",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Three Rivers Acupuncture & Herb LLC
• Sara Esther Torres
• Jennifer Lynn Truhlar, APRN
• Turtle Bloom Therapy, PLLC
• Stefanie Tyburczy
• Danielle Renee Vanderploeg
• Laura Ann Viita, OT
• Nichole Lynne Wajda, SLPA
• Frances Wedge, PT
• Stephanie Celena Whyte, M.D.

• Professional Counselor in Minooka, IL
• Providers in Minooka, IL by specialty
• Professional Counselor in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 10, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.