Active NPI
Agnieszka Magdalena Mantzas, LCPC, CEAP
- Professional Counselor
- Bloomingdale, IL
National Provider Identifier
1356013866
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Professional Counselor
- Practice address
- 132 W Lake Street #7
Bloomingdale, IL 60108 - Phone
- (224) 542-9900
- NPI assigned
- Oct 3, 2021
- 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 |
|---|---|---|---|---|
| Professional Counselor | 101YP2500X | Primary |
Addresses
Primary practice location
132 W Lake Street #7
Bloomingdale, IL 60108
Mailing address
808 N River Road 3B
Mount Prospect, IL 60056
Phone (224) 542-9900
Other practice location 1
808 N River Road 3B
Mount Prospect, IL 60056
Phone (224) 542-9900
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": "1633219200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1633219200000",
"number": "1356013866",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "808 N RIVER ROAD 3B",
"city": "MOUNT PROSPECT",
"state": "IL",
"postal_code": "60056",
"telephone_number": "224-542-9900"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "132 W LAKE STREET #7",
"city": "BLOOMINGDALE",
"state": "IL",
"postal_code": "60108",
"telephone_number": "224-542-9900"
}
],
"practiceLocations": [
{
"address_1": "808 N River Road 3B",
"address_purpose": "LOCATION",
"city": "Mount Prospect",
"state": "IL",
"postal_code": "60056",
"country_code": "US",
"telephone_number": "224-542-9900",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "MANTZAS",
"first_name": "AGNIESZKA",
"middle_name": "MAGDALENA",
"credential": "LCPC, CEAP",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2021-10-03",
"last_updated": "2021-10-03",
"certification_date": "2021-10-03",
"status": "A"
},
"taxonomies": [
{
"code": "101YP2500X",
"taxonomy_group": "",
"desc": "Counselor, Professional",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Bloomingdale, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 3, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.