Individual provider Active NPI

Tammy S Grode, M.A.,LCPC

  • Professional Counselor
  • Mokena, IL
National Provider Identifier
1396167201
Registry record updated Jul 14, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
180011275 Issued in IL
Practice address
9200 W 191St St Ste 6
Mokena, IL 60448
Phone
(708) 381-0108
NPI assigned
Jan 11, 2014
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 14, 2018

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Counselor 101Y00000X 178.009685 IL
Professional Counselor 101YP2500X 180011275 IL Primary

Addresses

Primary practice location

9200 W 191St St Ste 6
Mokena, IL 60448

Mailing address

9200 W 191St St Ste 6
Mokena, IL 60448-8730
Phone (708) 381-0108

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

State licenses

LicenseStateTypeSpecialty
178.009685ILMDCounselor
180011275ILMDProfessional Counselor

NPI Registry JSON

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

{
    "created_epoch": "1389398400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1531526400000",
    "number": "1396167201",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9200 W 191ST ST STE 6",
            "city": "MOKENA",
            "state": "IL",
            "postal_code": "604488730",
            "telephone_number": "708-381-0108"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9200 W 191ST ST STE 6",
            "city": "MOKENA",
            "state": "IL",
            "postal_code": "60448",
            "telephone_number": "708-381-0108"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRODE",
        "first_name": "TAMMY",
        "middle_name": "S",
        "credential": "M.A.,LCPC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2014-01-11",
        "last_updated": "2018-07-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": "IL",
            "license": "178.009685",
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "IL",
            "license": "180011275",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mokena, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 14, 2018; 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.