Individual provider Active NPI

Pneurissa Shanique Stamps, LCPC

  • Mental Health Counselor
  • Chicago, IL
National Provider Identifier
1306433503
Registry record updated Aug 19, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
180016304 Issued in IL
Practice address
155 N Michigan Ave Ste 9012
Chicago, IL 60601-7713
Phone
(331) 240-0044
NPI assigned
Dec 22, 2020
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 19, 2024

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 180016304 IL Primary

Addresses

Primary practice location

155 N Michigan Ave Ste 9012
Chicago, IL 60601-7713

Mailing address

6001 S Vernon Ave Apt 905
Chicago, IL 60637-2381
Phone (312) 504-6642

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
180016304ILMDMental Health Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Counseling Speaks Mental Health PastSince Dec 27, 2020 Accepting new patients

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": "1608595200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1724025600000",
    "number": "1306433503",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6001 S VERNON AVE APT 905",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606372381",
            "telephone_number": "312-504-6642"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "155 N MICHIGAN AVE STE 9012",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606017713",
            "telephone_number": "331-240-0044"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STAMPS",
        "first_name": "PNEURISSA",
        "middle_name": "SHANIQUE",
        "credential": "LCPC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-12-22",
        "last_updated": "2024-08-19",
        "certification_date": "2024-08-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "IL",
            "license": "180016304",
            "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 Aug 19, 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.

Verify at the official NPI Registry.