Individual provider Active NPI

Kahina Senice Ray, MS

  • Professional Counselor
  • Chicago, IL
National Provider Identifier
1407558380
Registry record updated Mar 21, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
Practice address
5035 S East End Ave Apt 3009S
Chicago, IL 60615-0062
Phone
(708) 674-9097
NPI assigned
Mar 21, 2023
Last updated
Mar 21, 2023By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 21, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Professional Counselor 101YP2500X Primary

Addresses

Primary practice location

5035 S East End Ave Apt 3009S
Chicago, IL 60615-0062

Mailing address

5035 S East End Ave Apt 3009S
Chicago, IL 60615-0062
Phone (708) 674-9097

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20250702003255 IL Practitioner - Mental Health Counselor 2769995620 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Rockford Psychiatric Medical Services SCGroup PAC ID 6901089515, 154 clinicians

Practice addresses (Care Compare)

9730 S Western Ave
Suite 230
Evergreen Park, IL 60805-2760
Phone (708) 734-9131

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Science

Practice roles

OrganizationSpecialtyStatusNew patients
Rockford Psychiatric Medical Services, S.C. CurrentSince Jun 25, 2025 Accepting new patients

Locations

1202 W Monroe St
Fl 1
Chicago, IL 60607
Phone (630) 517-2934

74 E 47TH St
Chicago, IL 60653

9730 S Western Ave
Ste 206
Evergreen Park, IL 60805
Phone (708) 475-0622

9730 S Western Ave
Ste 230
Evergreen Pk, IL 60805
Phone (708) 422-4944

1211 W 22nd St
Ste 406
Oak Brook, IL 60523

1639 N Alpine Rd
Ste 260
Rockford, IL 61107
Phone (815) 395-1500

Interoperability endpoints

  • Direct secure messaging: kahina.ray.1@25899.direct.athenahealth.com

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1679356800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1679356800000",
    "number": "1407558380",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5035 S EAST END AVE APT 3009S",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606150062",
            "telephone_number": "708-674-9097"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5035 S EAST END AVE APT 3009S",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606150062",
            "telephone_number": "708-674-9097"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RAY",
        "first_name": "KAHINA",
        "middle_name": "SENICE",
        "credential": "MS",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2023-03-21",
        "last_updated": "2023-03-21",
        "certification_date": "2023-03-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chicago, IL

Sources for this page

Verify at the official NPI Registry.