Individual provider Active NPI

Theresa L Randich, BA MHP

  • Professional Counselor
  • Winfield, IL
National Provider Identifier
1427453760
Registry record updated Sep 12, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
180.011783 Issued in IL
Practice address
28W671 Garys Mill Rd
Winfield, IL 60190-1564
Phone
(630) 293-9860
Fax
(630) 293-9861
NPI assigned
Oct 29, 2014
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 12, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X
Professional Counselor 101YP2500X 180.011783 IL Primary

Addresses

Primary practice location

28W671 Garys Mill Rd
Winfield, IL 60190-1564

Mailing address

28W671 Garys Mill Rd
Winfield, IL 60190-1564
Phone (630) 293-9860

Other practice location 1

111 N County Farm Rd
Wheaton, IL 60187-3977
Phone (630) 682-7400

Other practice location 2

3933 75th St Ste 102
Aurora, IL 60504-8015
Phone (630) 293-9860

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
I20241224000690 IL Practitioner - Mental Health Counselor 9335676709 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Pathways Psychology Services PCGroup PAC ID 5294918017, 12 clinicians

Practice addresses (Care Compare)

28 W671 Garys Mill Rd
Winfield, IL 60190-1564
Phone (630) 293-9860

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Bachelor of Arts

Practice roles

OrganizationSpecialtyStatusNew patients
Pathways Psychology Services P.C. CurrentSince Oct 19, 2024 Accepting new patients

Locations

3933 75th St
Ste 102
Aurora, IL 60504
Phone (630) 293-9860

28W671 Garys Mill Rd
Winfield, IL 60190
Phone (630) 293-9860

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": "1414540800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1662940800000",
    "number": "1427453760",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "28W671 GARYS MILL RD",
            "city": "WINFIELD",
            "state": "IL",
            "postal_code": "601901564",
            "telephone_number": "630-293-9860",
            "fax_number": "630-293-9861"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "28W671 GARYS MILL RD",
            "city": "WINFIELD",
            "state": "IL",
            "postal_code": "601901564",
            "telephone_number": "630-293-9860",
            "fax_number": "630-293-9861"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "111 N County Farm Rd",
            "address_purpose": "LOCATION",
            "city": "Wheaton",
            "state": "IL",
            "postal_code": "601873977",
            "country_code": "US",
            "telephone_number": "630-682-7400",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "3933 75th St Ste 102",
            "address_purpose": "LOCATION",
            "city": "Aurora",
            "state": "IL",
            "postal_code": "605048015",
            "country_code": "US",
            "telephone_number": "630-293-9860",
            "fax_number": "630-293-9861",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "RANDICH",
        "first_name": "THERESA",
        "middle_name": "L",
        "credential": "BA MHP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2014-10-29",
        "last_updated": "2022-09-12",
        "certification_date": "2022-09-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "IL",
            "license": "180.011783",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Winfield, IL

Sources for this page

Verify at the official NPI Registry.