Individual provider Active NPI

Deneen Amanda Holmes, MA LPC NCC ALMFT LPN

  • Professional Counselor
  • Flossmoor, IL
National Provider Identifier
1316748783
Registry record updated Mar 21, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
178.019884 Issued in IL
Practice address
19624 Governors Hwy
Flossmoor, IL 60422-2092
Phone
(872) 225-6010
NPI assigned
Mar 21, 2025
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 21, 2025

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Marriage & Family Therapist 106H00000X 208.001188 IL
Licensed Practical Nurse 164W00000X 043.116761 IL
Professional Counselor 101YP2500X 178.019884 IL Primary

Addresses

Primary practice location

19624 Governors Hwy
Flossmoor, IL 60422-2092

Mailing address

4820 179TH St
Country Club Hills, IL 60478-2918
Phone (708) 833-9298

Other practice location 1

15717 Wolf Rd
Orland Park, IL 60467-4543
Phone (331) 979-3136

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

LicenseStateTypeSpecialty
178.019884ILMDProfessional Counselor
208.001188ILMDMarriage & Family Therapist
043.116761ILMDLicensed Practical Nurse

NPI Registry JSON

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

{
    "created_epoch": "1742515200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1742515200000",
    "number": "1316748783",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4820 179TH ST",
            "city": "COUNTRY CLUB HILLS",
            "state": "IL",
            "postal_code": "604782918",
            "telephone_number": "708-833-9298"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "19624 GOVERNORS HWY",
            "city": "FLOSSMOOR",
            "state": "IL",
            "postal_code": "604222092",
            "telephone_number": "872-225-6010"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "15717 Wolf Rd",
            "address_purpose": "LOCATION",
            "city": "Orland Park",
            "state": "IL",
            "postal_code": "604674543",
            "country_code": "US",
            "telephone_number": "331-979-3136",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HOLMES",
        "first_name": "DENEEN",
        "middle_name": "AMANDA",
        "credential": "MA LPC NCC ALMFT LPN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-03-21",
        "last_updated": "2025-03-21",
        "certification_date": "2025-03-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "IL",
            "license": "208.001188",
            "primary": false
        },
        {
            "code": "164W00000X",
            "taxonomy_group": "",
            "desc": "Licensed Practical Nurse",
            "state": "IL",
            "license": "043.116761",
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "IL",
            "license": "178.019884",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Flossmoor, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 21, 2025; 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.