Active NPI
Kellie Marcus, MA
- Mental Health Counselor
- Elgin, IL
National Provider Identifier
1376037622
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Mental Health Counselor
- Practice address
- 1140 N McLean Blvd Ste 1
Elgin, IL 60123-1782 - Phone
- (847) 695-3680
- NPI assigned
- Jun 20, 2018
- Last updated
- Aug 28, 2019
- 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 |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | Primary |
Addresses
Primary practice location
1140 N McLean Blvd Ste 1
Elgin, IL 60123-1782
Mailing address
1532 Watkins LN Unit 201
Naperville, IL 60540-9271
Other practice location 1
106 S Lincolnway Ste F
North Aurora, IL 60542-1597
Phone (630) 801-1669
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
- Credentials
- Master of Arts
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1529452800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1566950400000",
"number": "1376037622",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1532 WATKINS LN UNIT 201",
"city": "NAPERVILLE",
"state": "IL",
"postal_code": "605409271"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1140 N MCLEAN BLVD STE 1",
"city": "ELGIN",
"state": "IL",
"postal_code": "601231782",
"telephone_number": "847-695-3680"
}
],
"practiceLocations": [
{
"address_1": "106 S Lincolnway Ste F",
"address_purpose": "LOCATION",
"city": "North Aurora",
"state": "IL",
"postal_code": "605421597",
"country_code": "US",
"telephone_number": "630-801-1669",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "MARCUS",
"first_name": "KELLIE",
"credential": "MA",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2018-06-20",
"last_updated": "2019-08-28",
"status": "A"
},
"taxonomies": [
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Elgin, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 28, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.