Individual provider Active NPI

Susan Siokos, EDD, LCPC

  • Mental Health Counselor
  • Evanston, IL
National Provider Identifier
1356101646
Registry record updated Mar 21, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
180.011482 Issued in IL
Practice address
1123 Maple Ave Apt 3N
Evanston, IL 60202-4252
Phone
(773) 704-0424
NPI assigned
Mar 21, 2024
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 21, 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 180.011482 IL Primary

Addresses

Primary practice location

1123 Maple Ave Apt 3N
Evanston, IL 60202-4252

Mailing address

PO Box 5129
Evanston, IL 60204-5129
Phone (773) 704-0424

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
180.011482ILMDMental Health Counselor

NPI Registry JSON

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

{
    "created_epoch": "1710979200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1710979200000",
    "number": "1356101646",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 5129",
            "city": "EVANSTON",
            "state": "IL",
            "postal_code": "602045129",
            "telephone_number": "773-704-0424"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1123 MAPLE AVE APT 3N",
            "city": "EVANSTON",
            "state": "IL",
            "postal_code": "602024252",
            "telephone_number": "773-704-0424"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SIOKOS",
        "first_name": "SUSAN",
        "name_prefix": "Dr.",
        "credential": "EDD, LCPC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2024-03-21",
        "last_updated": "2024-03-21",
        "certification_date": "2024-03-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "IL",
            "license": "180.011482",
            "primary": true
        }
    ],
    "identifiers": [],
    "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 Mar 21, 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.