Individual provider Active NPI

Coral Nicole Pidone, LCPC

  • Counselor
  • Lisle, IL
National Provider Identifier
1376018259
Registry record updated May 15, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
CounselorTaxonomy code 101Y00000X
License
180.014151 Issued in IL
Practice address
4300 Commerce CT
Lisle, IL 60532-3709
Phone
(708) 465-1242
NPI assigned
Oct 8, 2018
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 15, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Professional Counselor 101YP2500X
CounselorGroup: 193400000X SINGLE SPECIALTY GROUP 101Y00000X 180.014151 IL Primary

Addresses

Primary practice location

4300 Commerce CT
Lisle, IL 60532-3709

Mailing address

346 Deering LN
Bolingbrook, IL 60440-6165

Other practice location 1

3436 N Kennicott Ave
Arlington Hts, IL 60004-7814
Phone (847) 952-7460

Other practice location 2

311 N 2nd St Ste 207
St Charles, IL 60174-1852
Phone (630) 797-9192

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
180.014151ILMDCounselor

Practice roles

OrganizationSpecialtyStatusNew patients
One Counseling LLC Professional CurrentSince May 19, 2024 Accepting new patients
Kane County Counseling Services LLC Past Accepting new patients

Locations

4300 Commerce Ct
Ste 300
Lisle, IL 60532
Phone (309) 258-8851

4300 Commerce Ct
Ste 30015
Lisle, IL 60532

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": "1538956800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1715731200000",
    "number": "1376018259",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "346 DEERING LN",
            "city": "BOLINGBROOK",
            "state": "IL",
            "postal_code": "604406165"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4300 COMMERCE CT",
            "city": "LISLE",
            "state": "IL",
            "postal_code": "605323709",
            "telephone_number": "708-465-1242"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3436 N Kennicott Ave",
            "address_purpose": "LOCATION",
            "city": "Arlington Hts",
            "state": "IL",
            "postal_code": "600047814",
            "country_code": "US",
            "telephone_number": "847-952-7460",
            "fax_number": "847-222-1754",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "311 N 2nd St Ste 207",
            "address_purpose": "LOCATION",
            "city": "St Charles",
            "state": "IL",
            "postal_code": "601741852",
            "country_code": "US",
            "telephone_number": "630-797-9192",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PIDONE",
        "first_name": "CORAL",
        "middle_name": "NICOLE",
        "credential": "LCPC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-10-08",
        "last_updated": "2024-05-15",
        "certification_date": "2024-05-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "101Y00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Counselor",
            "state": "IL",
            "license": "180.014151",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lisle, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 15, 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.