Active NPI
Carrie Shalosky
- Counselor
- Carbondale, IL
National Provider Identifier
1366033466
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Counselor
- Practice address
- 200 N Emerald LN
Carbondale, IL 62901-2159 - Phone
- (618) 440-0418
- NPI assigned
- Feb 1, 2021
- Sex
- Female
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Counselor | 101Y00000X | Primary |
Addresses
Primary practice location
200 N Emerald LN
Carbondale, IL 62901-2159
Mailing address
902 W Main St
West Frankfort, IL 62896-2210
Phone (618) 937-6483
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
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20260605000946 | IL | Practitioner - Mental Health Counselor | 0446721948 | Reassigns benefits to 1 organization |
Care Compare profile
Medicare Care Compare- Specialty
- Mental Health Counselor
- Education
- Other, 2002
- Medicare assignment
- May accept Medicare assignment
Practice addresses (Care Compare)
8601 W Main St
Suite 201
Belleville, IL 62223-1788
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
Organizations & group practices 1
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.
-
- Mental Health Clinic/Center (Including Community Mental Health Center)
- Belleville, IL
- NPI 1154399780
IL
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1612137600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1612310400000",
"number": "1366033466",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "902 W MAIN ST",
"city": "WEST FRANKFORT",
"state": "IL",
"postal_code": "628962210",
"telephone_number": "618-937-6483"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "200 N EMERALD LN",
"city": "CARBONDALE",
"state": "IL",
"postal_code": "629012159",
"telephone_number": "618-440-0418"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SHALOSKY",
"first_name": "CARRIE",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2021-02-01",
"last_updated": "2021-02-03",
"certification_date": "2021-02-03",
"status": "A"
},
"taxonomies": [
{
"code": "101Y00000X",
"taxonomy_group": "",
"desc": "Counselor",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Carbondale, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 3, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.