Individual provider Active NPI

Sheila Senn, LCPC

  • Professional Counselor
  • Cary, IL
National Provider Identifier
1265440671
Registry record updated Jul 4, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
180-005067 Issued in IL
Practice address
114 Cary St
Cary, IL 60013-2706
Phone
(815) 687-6955
NPI assigned
Aug 3, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 4, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Professional Counselor 101YP2500X 180-005067 IL Primary

Addresses

Primary practice location

114 Cary St
Cary, IL 60013-2706

Mailing address

468 Rockland Rd
Crystal Lake, IL 60014-4120
Phone (815) 687-6955

Other identifiers 2

IdentifierTypeStateIssuer
180-005067OtherILSTATE LICENSE
0005632124OtherILBCBS

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

LicenseStateTypeSpecialty
180-005067ILMDProfessional Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Well Spring Counseling and Executive Coaching LLC Professional CurrentSince Jun 27, 2021 Accepting new patients

Locations

114 Cary St
Cary, IL 60013
Phone (815) 669-9590

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": "1154563200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1593820800000",
    "number": "1265440671",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "468 ROCKLAND RD",
            "city": "CRYSTAL LAKE",
            "state": "IL",
            "postal_code": "600144120",
            "telephone_number": "815-687-6955"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "114 CARY ST",
            "city": "CARY",
            "state": "IL",
            "postal_code": "600132706",
            "telephone_number": "815-687-6955"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SENN",
        "first_name": "SHEILA",
        "credential": "LCPC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-03",
        "last_updated": "2020-07-04",
        "certification_date": "2020-07-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "IL",
            "license": "180-005067",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE LICENSE",
            "identifier": "180-005067",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "0005632124",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Cary, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 4, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.