Active NPI
Maria Mangiardi, LCPC
- Professional Counselor
- Crystal Lake, IL
National Provider Identifier
1427423748
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Professional Counselor
- License
- 180-013347
- Practice address
- 185 Heritage Dr Ste 1B
Crystal Lake, IL 60014-8059 - Phone
- (815) 477-4727
- NPI assigned
- Dec 11, 2015
- 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 | 180-013347 | IL | Primary |
Addresses
Primary practice location
185 Heritage Dr Ste 1B
Crystal Lake, IL 60014-8059
Mailing address
34220 N Bluestem Rd
Round Lake, IL 60073-5245
Phone (847) 942-8789
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 |
|---|---|---|---|
| 180-013347 | IL | MD | Professional Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1449792000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1684886400000",
"number": "1427423748",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "34220 N BLUESTEM RD",
"city": "ROUND LAKE",
"state": "IL",
"postal_code": "600735245",
"telephone_number": "847-942-8789"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "185 HERITAGE DR STE 1B",
"city": "CRYSTAL LAKE",
"state": "IL",
"postal_code": "600148059",
"telephone_number": "815-477-4727"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MANGIARDI",
"first_name": "MARIA",
"credential": "LCPC",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2015-12-11",
"last_updated": "2023-05-24",
"certification_date": "2023-05-24",
"status": "A"
},
"taxonomies": [
{
"code": "101YP2500X",
"taxonomy_group": "",
"desc": "Counselor, Professional",
"state": "IL",
"license": "180-013347",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Crystal Lake, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 24, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.