Individual provider Active NPI

Melissa Schleicher-Park, LCPC, BC-DMT

  • Professional Counselor
  • Evanston, IL
National Provider Identifier
1265823942
Registry record updated Nov 24, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
180-010156 Issued in IL
Practice address
1818 Dempster St
Evanston, IL 60202-1003
Phone
(773) 547-9545
NPI assigned
Feb 17, 2015
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 24, 2019

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 180-010156 IL Primary

Addresses

Primary practice location

1818 Dempster St
Evanston, IL 60202-1003

Mailing address

1818 Dempster St
Evanston, IL 60202-1003
Phone (773) 547-9545

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
180-010156ILMDProfessional Counselor

NPI Registry JSON

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

{
    "created_epoch": "1424131200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1574553600000",
    "number": "1265823942",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1818 DEMPSTER ST",
            "city": "EVANSTON",
            "state": "IL",
            "postal_code": "602021003",
            "telephone_number": "773-547-9545"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1818 DEMPSTER ST",
            "city": "EVANSTON",
            "state": "IL",
            "postal_code": "602021003",
            "telephone_number": "773-547-9545"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SCHLEICHER-PARK",
        "first_name": "MELISSA",
        "credential": "LCPC, BC-DMT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2015-02-17",
        "last_updated": "2019-11-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "IL",
            "license": "180-010156",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Evanston, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 24, 2019; 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.