Individual provider Active NPI

Terry Mark Ledford

  • Mental Health Counselor
  • Chicago, IL
National Provider Identifier
1427775774
Registry record updated Oct 26, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
178018268 Issued in IL
Practice address
3660 N Lake Shore Dr Ste 210
Chicago, IL 60613-5302
Phone
(704) 743-4295
NPI assigned
Oct 26, 2022
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 26, 2022

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 178018268 IL Primary

Addresses

Primary practice location

3660 N Lake Shore Dr Ste 210
Chicago, IL 60613-5302

Mailing address

5828 N Paulina St Apt 2S
Chicago, IL 60660-3278
Phone (773) 505-6958

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
178018268ILMDMental Health Counselor

NPI Registry JSON

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

{
    "created_epoch": "1666742400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1666742400000",
    "number": "1427775774",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5828 N PAULINA ST APT 2S",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606603278",
            "telephone_number": "773-505-6958"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3660 N LAKE SHORE DR STE 210",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606135302",
            "telephone_number": "704-743-4295"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEDFORD",
        "first_name": "TERRY",
        "middle_name": "MARK",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2022-10-26",
        "last_updated": "2022-10-26",
        "certification_date": "2022-10-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "IL",
            "license": "178018268",
            "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 Oct 26, 2022; 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.