Individual provider Active NPI

Clara Varlese, LCPC,NCC

  • Mental Health Counselor
  • Bloomington, IL
National Provider Identifier
1295086056
Registry record updated Jan 23, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
005165 Issued in NY
Practice address
1224 Towanda Ave Ste 22
Bloomington, IL 61701-7414
Phone
(917) 743-3601
NPI assigned
Sep 19, 2012
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 23, 2020

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 005165 NY Primary

Addresses

Primary practice location

1224 Towanda Ave Ste 22
Bloomington, IL 61701-7414

Mailing address

1224 Towanda Ave Ste 22
Bloomington, IL 61701-7414
Phone (917) 743-3601

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
005165NYMDPhysical Therapy Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Clara Varlese Counseling, PLLC Current Accepting new patients

Locations

1224 Towanda Ave
Ste 22
Bloomington, IL 61701
Phone (309) 838-7586

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": "1348012800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1579737600000",
    "number": "1295086056",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1224 TOWANDA AVE STE 22",
            "city": "BLOOMINGTON",
            "state": "IL",
            "postal_code": "617017414",
            "telephone_number": "917-743-3601"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1224 TOWANDA AVE STE 22",
            "city": "BLOOMINGTON",
            "state": "IL",
            "postal_code": "617017414",
            "telephone_number": "917-743-3601"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VARLESE",
        "first_name": "CLARA",
        "name_prefix": "Ms.",
        "credential": "LCPC,NCC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-09-19",
        "last_updated": "2020-01-23",
        "certification_date": "2020-01-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "NY",
            "license": "005165",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bloomington, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 23, 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.