Active NPI
Michelle Diaz, MS, LPC, NCC
- Professional Counselor
- McHenry, IL
National Provider Identifier
1255847422
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Professional Counselor
- License
- 178.013346
- Practice address
- 4209 W Shamrock LN
McHenry, IL 60050-8700 - Phone
- (815) 344-9443
- Fax
- (815) 344-9445
- NPI assigned
- Dec 23, 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 | 178.013346 | IL | Primary |
Addresses
Primary practice location
4209 W Shamrock LN
McHenry, IL 60050-8700
Mailing address
35W735 Crispin Dr
Elgin, IL 60123-6724
Phone (224) 829-2535
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
- Credentials
- Master of Science
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 178.013346 | IL | MD | Professional Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1513987200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1513987200000",
"number": "1255847422",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "35W735 CRISPIN DR",
"city": "ELGIN",
"state": "IL",
"postal_code": "601236724",
"telephone_number": "224-829-2535"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4209 W SHAMROCK LN",
"city": "MCHENRY",
"state": "IL",
"postal_code": "600508700",
"telephone_number": "815-344-9443",
"fax_number": "815-344-9445"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DIAZ",
"first_name": "MICHELLE",
"credential": "MS, LPC, NCC",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2017-12-23",
"last_updated": "2017-12-23",
"status": "A"
},
"taxonomies": [
{
"code": "101YP2500X",
"taxonomy_group": "",
"desc": "Counselor, Professional",
"state": "IL",
"license": "178.013346",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in McHenry, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 23, 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.