Individual provider Active NPI

Nathan Kretlow, MS, LPC

  • Mental Health Counselor
  • Chicago, IL
National Provider Identifier
1295419976
Registry record updated Jun 13, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
10386-125 Issued in WI
Practice address
225 N Michigan Ave Ste 1430
Chicago, IL 60601-7653
Phone
(312) 766-6780
NPI assigned
Jun 13, 2023
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 13, 2023

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 10386-125 WI Primary

Addresses

Primary practice location

225 N Michigan Ave Ste 1430
Chicago, IL 60601-7653

Mailing address

5505 N Cumberland Ave
Ste 307 Attn 18205
Chicago, IL 60656-4761

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

LicenseStateTypeSpecialty
10386-125WIMDMental Health Counselor

NPI Registry JSON

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

{
    "created_epoch": "1686614400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1686614400000",
    "number": "1295419976",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5505 N CUMBERLAND AVE",
            "address_2": "STE 307 ATTN 18205",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606564761"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "225 N MICHIGAN AVE STE 1430",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606017653",
            "telephone_number": "312-766-6780"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KRETLOW",
        "first_name": "NATHAN",
        "credential": "MS, LPC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2023-06-13",
        "last_updated": "2023-06-13",
        "certification_date": "2023-06-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "WI",
            "license": "10386-125",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chicago, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 13, 2023; 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.