Active NPI
Kristen C Hammel
- Professional Counselor
- Potomac, IL
National Provider Identifier
1396225199
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Professional Counselor
- License
- 180.011168
- Practice address
- 7757 US-136
Potomac, IL 61865 - Phone
- (217) 649-0492
- NPI assigned
- Aug 21, 2018
- Last updated
- Aug 21, 2018
- 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 |
|---|---|---|---|---|
| Professional Counselor | 101YP2500X | 180.011168 | IL | Primary |
Addresses
Primary practice location
7757 US-136
Potomac, IL 61865
Mailing address
1415 Cobblestone Way
Champaign, IL 61822-2068
Phone (217) 377-9347
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
| License | State | Type | Specialty |
|---|---|---|---|
| 180.011168 | IL | MD | Professional Counselor |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Willow Counseling LLC | Current | Accepting new patients | |
| Gateway Family Services of Illinois | Professional | Past | Accepting new patients |
Locations
1801 Woodfield Dr
Ste 301
Savoy, IL 61874
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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
- Social Worker
- Champaign, IL
- NPI 1609427269
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1534809600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1534809600000",
"number": "1396225199",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1415 COBBLESTONE WAY",
"city": "CHAMPAIGN",
"state": "IL",
"postal_code": "618222068",
"telephone_number": "217-377-9347"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "7757 US-136",
"city": "POTOMAC",
"state": "IL",
"postal_code": "61865",
"telephone_number": "217-649-0492"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HAMMEL",
"first_name": "KRISTEN",
"middle_name": "C",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2018-08-21",
"last_updated": "2018-08-21",
"status": "A"
},
"taxonomies": [
{
"code": "101YP2500X",
"taxonomy_group": "",
"desc": "Counselor, Professional",
"state": "IL",
"license": "180.011168",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Potomac, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 21, 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.