Individual provider Active NPI

Tiffany Bernard, LPC

  • Professional Counselor
  • Chicago, IL
National Provider Identifier
1417628736
Registry record updated Sep 27, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
178.010027 Issued in IL
Practice address
333 N Michigan Ave Ste 1400
Chicago, IL 60601-4011
Phone
(312) 815-9660
NPI assigned
Sep 27, 2021
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 27, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Professional CounselorGroup: 193400000X SINGLE SPECIALTY GROUP 101YP2500X 178.010027 IL Primary

Addresses

Primary practice location

333 N Michigan Ave Ste 1400
Chicago, IL 60601-4011

Mailing address

5136 S Kimbark Ave
Chicago, IL 60615-3834
Phone (773) 822-1719

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
178.010027ILMDProfessional Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Clarity Clinic PLLC Single Specialty CurrentSince Oct 5, 2021 Accepting new patients

Locations

333 N Michigan Ave
Ste 1400
Chicago, IL 60601
Phone (312) 815-9660

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1632700800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1632700800000",
    "number": "1417628736",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5136 S KIMBARK AVE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606153834",
            "telephone_number": "773-822-1719"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "333 N MICHIGAN AVE STE 1400",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606014011",
            "telephone_number": "312-815-9660"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BERNARD",
        "first_name": "TIFFANY",
        "credential": "LPC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-09-27",
        "last_updated": "2021-09-27",
        "certification_date": "2021-09-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Counselor, Professional",
            "state": "IL",
            "license": "178.010027",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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 Sep 27, 2021; 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.