Individual provider Active NPI

Danielle Shaw

  • Mental Health Counselor
  • Chicago, IL
National Provider Identifier
1417575408
Registry record updated Jul 7, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
Practice address
1438 W Belmont Ave Ste 1
Chicago, IL 60657-2166
Phone
(312) 508-3645
NPI assigned
Jul 7, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 7, 2020

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 Primary

Addresses

Primary practice location

1438 W Belmont Ave Ste 1
Chicago, IL 60657-2166

Mailing address

262 E Saint Charles Rd Apt Ga
Carol Stream, IL 60188-2325

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
I20250806002679 IL Practitioner - Mental Health Counselor 3476061730 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Light on Anxiety, P.C. Mental Health CurrentSince Aug 23, 2020 Accepting new patients
Bellosa Counseling, LLC Mental Health CurrentSince Jul 10, 2025 Accepting new patients

Locations

1438 W Belmont Ave
Ste 1
Chicago, IL 60657
Phone 3125083645 ext. 36

1580 N Northwest Hwy
Ste 120
Park Ridge, IL 60068
Phone (847) 220-4977

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1594080000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1594080000000",
    "number": "1417575408",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "262 E SAINT CHARLES RD APT GA",
            "city": "CAROL STREAM",
            "state": "IL",
            "postal_code": "601882325"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1438 W BELMONT AVE STE 1",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606572166",
            "telephone_number": "312-508-3645"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHAW",
        "first_name": "DANIELLE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-07-07",
        "last_updated": "2020-07-07",
        "certification_date": "2020-07-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "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.