Individual provider Active NPI

Mary Garza, LPC

  • Mental Health Counselor
  • Crystal Lake, IL
National Provider Identifier
1336903350
Registry record updated Mar 11, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
178020279 Issued in IL
Practice address
650 Dakota St Ste a
Crystal Lake, IL 60012-3744
Phone
(815) 455-6000
NPI assigned
Feb 9, 2024
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 11, 2025

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Counselor 101Y00000X
Mental Health Counselor 101YM0800X IL
Mental Health Counselor 101YM0800X 178020279 IL Primary

Addresses

Primary practice location

650 Dakota St Ste a
Crystal Lake, IL 60012-3744

Mailing address

650 Dakota St Ste a
Crystal Lake, IL 60012-3744
Phone (815) 334-5018

Other practice location 1

650 Dakota St Ste A
Crystal Lake, IL 60012-3744
Phone (815) 334-5018

Other names 1

  • Mary Krutz Other name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240902000144 IL Practitioner - Mental Health Counselor 0749729911 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Central Dupage Physician GroupGroup PAC ID 5890696231, 1,087 clinicians

Practice addresses (Care Compare)

650 Dakota St
Suite a
Crystal Lake, IL 60012-3744
Phone (815) 455-6000

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
178020279ILMDMental Health Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Central Dupage Physician Group CurrentSince Jun 23, 2024 Accepting new patients
Central Dupage Physician Group CurrentSince Jun 23, 2024 Accepting new patients

Locations

Dept 5777
Carol Stream, IL 60122

Carol Stream, IL 60122
Phone (630) 933-3300

650 Dakota St
Ste A
Crystal Lake, IL 60012
Phone (815) 334-5018

1800 N Main St
Wheaton, IL 60187
Phone (630) 469-0045

Organizations & group practices 2

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": "1707436800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1741651200000",
    "number": "1336903350",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "650 DAKOTA ST STE A",
            "city": "CRYSTAL LAKE",
            "state": "IL",
            "postal_code": "600123744",
            "telephone_number": "815-334-5018",
            "fax_number": "815-356-1104"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "650 DAKOTA ST STE A",
            "city": "CRYSTAL LAKE",
            "state": "IL",
            "postal_code": "600123744",
            "telephone_number": "815-455-6000"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "650 Dakota St Ste A",
            "address_purpose": "LOCATION",
            "city": "Crystal Lake",
            "state": "IL",
            "postal_code": "600123744",
            "country_code": "US",
            "telephone_number": "815-334-5018",
            "fax_number": "815-356-1104",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GARZA",
        "first_name": "MARY",
        "credential": "LPC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-02-09",
        "last_updated": "2025-03-11",
        "certification_date": "2025-03-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "IL",
            "license": null,
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "IL",
            "license": "178020279",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MARY",
            "last_name": "KRUTZ",
            "credential": "LPC",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Crystal Lake, IL

Sources for this page

Verify at the official NPI Registry.