Active NPI
Rachel Lee Gussman
- Counselor
- Crystal Lake, IL
National Provider Identifier
1295554855
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Counselor
- Practice address
- 650 E Terra Cotta Ave Ste 100
Crystal Lake, IL 60014-3654 - Phone
- (206) 465-3502
- NPI assigned
- Oct 9, 2024
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Counselor | 101Y00000X | Primary |
Addresses
Primary practice location
650 E Terra Cotta Ave Ste 100
Crystal Lake, IL 60014-3654
Mailing address
1181 Sugar Maple Dr
Crystal Lake, IL 60012-3801
Phone (206) 465-3502
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
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1728432000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1728432000000",
"number": "1295554855",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1181 SUGAR MAPLE DR",
"city": "CRYSTAL LAKE",
"state": "IL",
"postal_code": "600123801",
"telephone_number": "206-465-3502"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "650 E TERRA COTTA AVE STE 100",
"city": "CRYSTAL LAKE",
"state": "IL",
"postal_code": "600143654",
"telephone_number": "206-465-3502"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GUSSMAN",
"first_name": "RACHEL",
"middle_name": "LEE",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2024-10-09",
"last_updated": "2024-10-09",
"certification_date": "2024-10-09",
"status": "A"
},
"taxonomies": [
{
"code": "101Y00000X",
"taxonomy_group": "",
"desc": "Counselor",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Crystal Lake, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 9, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.