Individual provider Active NPI

Maria Nadupparambil

  • Mental Health Counselor
  • New Lenox, IL
National Provider Identifier
1285304071
Registry record updated Sep 14, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
178017391 Issued in IL
Practice address
1005 W Laraway Rd Ste 130
New Lenox, IL 60451-2461
Phone
(815) 570-9303
NPI assigned
Sep 14, 2021
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 14, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X 178017391 IL Primary

Addresses

Primary practice location

1005 W Laraway Rd Ste 130
New Lenox, IL 60451-2461

Mailing address

2219 Hiawatha Pkwy
Woodridge, IL 60517-3509
Phone (815) 570-9303

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
I20260612000249 IL Practitioner - Mental Health Counselor 0345712139 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 2021
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

1021 N Mulford Rd
Rockford, IL 61107-3874

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
178017391ILMDMental Health Counselor

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": "1631577600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1631577600000",
    "number": "1285304071",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2219 HIAWATHA PKWY",
            "city": "WOODRIDGE",
            "state": "IL",
            "postal_code": "605173509",
            "telephone_number": "815-570-9303",
            "fax_number": "866-950-9427"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1005 W LARAWAY RD STE 130",
            "city": "NEW LENOX",
            "state": "IL",
            "postal_code": "604512461",
            "telephone_number": "815-570-9303"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NADUPPARAMBIL",
        "first_name": "MARIA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-09-14",
        "last_updated": "2021-09-14",
        "certification_date": "2021-09-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "IL",
            "license": "178017391",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New Lenox, IL

Sources for this page

Verify at the official NPI Registry.