Kerry Lynn O'Donnell, LPC

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

178.011125 Issued in IL

Practice address

412 N Lake St
Suite 204
Aurora, IL 60506-4106

Phone

(630) 292-3815

Fax

(630) 896-3515

NPI assigned

Aug 4, 2015

Last updated

Aug 4, 2015By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in IL

Eligible to order & refer

• Part B services: No
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Gateway Psychological Services, LTD

  • Clinical Psychologist
  • Aurora, IL
  • NPI 1619163268
  Medicare reassignment NPD

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

{
    "created_epoch": "1438646400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1438646400000",
    "number": "1417333287",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "412 N LAKE ST",
            "city": "AURORA",
            "state": "IL",
            "postal_code": "605064106",
            "telephone_number": "630-896-2337",
            "fax_number": "630-896-3515"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "412 N LAKE ST",
            "address_2": "SUITE 204",
            "city": "AURORA",
            "state": "IL",
            "postal_code": "605064106",
            "telephone_number": "630-292-3815",
            "fax_number": "630-896-3515"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "O'DONNELL",
        "first_name": "KERRY",
        "middle_name": "LYNN",
        "name_prefix": "Mrs.",
        "credential": "LPC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-08-04",
        "last_updated": "2015-08-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "IL",
            "license": "178.011125",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Erin Michelle O'Brien, MA, BCBA
• William J O'Brien, MD
• Bryan O'Connor, PT, DPT
• Sarah O'Connor
• Scott M O'Connor, M.D.
• Mary Elizabeth O'Donnell, PA-C
• Brian J O'Donovan, D.D.S.
• John O'Dwyer Jr., R.PH.
• Brianne O'Leary, CSFA
• Kristen Elizabeth O'Leary, MA., CF-SLP

• Professional Counselor in Aurora, IL
• Providers in Aurora, IL by specialty
• Professional Counselor in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 4, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.