Individual provider Active NPI

Mary Ann Ruth Monahan, LCPC

  • Mental Health Counselor
  • Chicago, IL
National Provider Identifier
1396169637
Registry record updated Feb 6, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
180.004579 Issued in IL
Practice address
735 W. 35TH Street
1St Floor
Chicago, IL 60616
Phone
(312) 339-1749
Fax
(773) 254-8944
NPI assigned
Feb 6, 2014
Last updated
Feb 6, 2014By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 6, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X 180.004579 IL Primary

Addresses

Primary practice location

735 W. 35TH Street
1St Floor
Chicago, IL 60616

Mailing address

1717 South Prairie Avenue
#1004
Chicago, IL 60616
Phone (312) 339-1749

Other names 1

  • Miss Mary Ann Ruth Pusateri Former name

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
180.004579ILMDMental Health Counselor

NPI Registry JSON

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

{
    "created_epoch": "1391644800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1391644800000",
    "number": "1396169637",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1717 SOUTH PRAIRIE AVENUE",
            "address_2": "#1004",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "60616",
            "telephone_number": "312-339-1749",
            "fax_number": "773-254-8944"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "735 W. 35TH STREET",
            "address_2": "1ST FLOOR",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "60616",
            "telephone_number": "312-339-1749",
            "fax_number": "773-254-8944"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MONAHAN",
        "first_name": "MARY ANN",
        "middle_name": "RUTH",
        "name_prefix": "Mrs.",
        "credential": "LCPC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2014-02-06",
        "last_updated": "2014-02-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "IL",
            "license": "180.004579",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MARY ANN",
            "last_name": "PUSATERI",
            "middle_name": "RUTH",
            "prefix": "MISS",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Chicago, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 6, 2014; 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.