Active NPI
Aquanetta Kristine Hart
- Mental Health Counselor
- Homewood, IL
National Provider Identifier
1427620004
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Mental Health Counselor
- Practice address
- 2023 Ridge Rd Unit 2NW
Homewood, IL 60430-1786 - Phone
- (708) 580-6042
- NPI assigned
- Jul 13, 2021
- 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 |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | Primary |
Addresses
Primary practice location
2023 Ridge Rd Unit 2NW
Homewood, IL 60430-1786
Mailing address
3950 N Lake Shore Dr Apt 826E
Chicago, IL 60613-3434
Phone (219) 718-0157
Other practice location 1
3950 N Lake Shore Dr Apt 826
Chicago, IL 60613-3442
Phone (219) 718-0157
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
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Soul Werk Cafe PLLC | Mental Health | Past | Accepting new patients |
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": "1626134400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1626134400000",
"number": "1427620004",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3950 N LAKE SHORE DR APT 826E",
"city": "CHICAGO",
"state": "IL",
"postal_code": "606133434",
"telephone_number": "219-718-0157"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2023 RIDGE RD UNIT 2NW",
"city": "HOMEWOOD",
"state": "IL",
"postal_code": "604301786",
"telephone_number": "708-580-6042"
}
],
"practiceLocations": [
{
"address_1": "3950 N Lake Shore Dr Apt 826",
"address_purpose": "LOCATION",
"city": "Chicago",
"state": "IL",
"postal_code": "606133442",
"country_code": "US",
"telephone_number": "219-718-0157",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "HART",
"first_name": "AQUANETTA",
"middle_name": "KRISTINE",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2021-07-13",
"last_updated": "2021-07-13",
"certification_date": "2021-07-13",
"status": "A"
},
"taxonomies": [
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Homewood, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 13, 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.