John Brian Fuente, LPC

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

178.016822 Issued in IL

Practice address

1010 Lake St Ste 200
Oak Park, IL 60301-1132

Phone

(312) 809-0298

NPI assigned

Sep 14, 2020

Sex

Male

Sole proprietor

No

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.

• Wildflower Center for Emotional Health PLLC

  • Clinical Social Worker
  • Chicago, IL
  • NPI 1114342599
  NPD

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Opted out of Medicare

Yes, effective Jan 25, 2024 through Jan 25, 2028

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Locations

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Mar 23, 2021.

{
    "created_epoch": "1600041600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1616457600000",
    "number": "1356956502",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "820 N ORLEANS ST STE 350",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606103145",
            "telephone_number": "312-809-0298"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1010 LAKE ST STE 200",
            "city": "OAK PARK",
            "state": "IL",
            "postal_code": "603011132",
            "telephone_number": "312-809-0298"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "820 N Orleans St Ste 350",
            "address_purpose": "LOCATION",
            "city": "Chicago",
            "state": "IL",
            "postal_code": "606103145",
            "country_code": "US",
            "telephone_number": "312-809-0298",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "FUENTE",
        "first_name": "JOHN",
        "middle_name": "BRIAN",
        "name_prefix": "Mr.",
        "credential": "LPC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-09-14",
        "last_updated": "2021-03-23",
        "certification_date": "2021-03-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "IL",
            "license": "178.016822",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Fresenius Medical Care River Forest, LLC
• Jamie Friedman, MS OTR/L
• Mary Lou Friedman, LMFT
• Jereme Froehlich, CRNA
• Jennifer C Froemel, M.A., L.C.P.C.
• Fuller Health Group SC
• Brian Jay Fuller, D.C.
• Daniel P Fulton, MA
• Funches Healthcare PLLC Dba Virtual Health 78 & Wellness Center
• Functional Health and Wellness

• All providers in Oak Park, IL
• Professional Counselor in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 23, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.