Active NPI
Susan Thompson, MA,LCPC,ATR
- Professional Counselor
- Evanston, IL
National Provider Identifier
1295917953
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Professional Counselor
- License
- 180000932
- Practice address
- 2550 Crawford Ave
Suite 5
Evanston, IL 60201-4900 - Phone
- (773) 960-8359
- NPI assigned
- Dec 4, 2007
- Sex
- Female
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Professional Counselor | 101YP2500X | 180000932 | IL | Primary |
Addresses
Primary practice location
2550 Crawford Ave
Suite 5
Evanston, IL 60201-4900
Mailing address
2550 Crawford Ave
Suite 5
Evanston, IL 60201-4900
Phone (773) 960-8359
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 103637507 | Other | UBH | |
| 0001634445 | Other | BCBSIL |
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 Arts
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 180000932 | IL | MD | Professional Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1196726400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1355097600000",
"number": "1295917953",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2550 CRAWFORD AVE",
"address_2": "SUITE 5",
"city": "EVANSTON",
"state": "IL",
"postal_code": "602014900",
"telephone_number": "773-960-8359"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2550 CRAWFORD AVE",
"address_2": "SUITE 5",
"city": "EVANSTON",
"state": "IL",
"postal_code": "602014900",
"telephone_number": "773-960-8359"
}
],
"practiceLocations": [],
"basic": {
"last_name": "THOMPSON",
"first_name": "SUSAN",
"credential": "MA,LCPC,ATR",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-12-04",
"last_updated": "2012-12-10",
"status": "A"
},
"taxonomies": [
{
"code": "101YP2500X",
"taxonomy_group": "",
"desc": "Counselor, Professional",
"state": "IL",
"license": "180000932",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "UBH",
"identifier": "103637507",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BCBSIL",
"identifier": "0001634445",
"state": null
}
],
"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 Dec 10, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.