Organization Active NPI

Secure Roots Therapy PLLC

  • Mental Health Counselor
  • Oak Forest, IL
National Provider Identifier
1447198452
Registry record updated Aug 3, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
Legal business name
SECURE ROOTS THERAPY PLLC
Practice address
4845 167TH St
Oak Forest, IL 60452-4507
Phone
(708) 247-5818
NPI assigned
Mar 23, 2026
Last updated
Aug 3, 2026By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 3, 2026

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

Authorized official

Name
Kayla Lucas, LCPCNPI 1922869965
Title
Owner
Phone
(708) 247-5818

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X NU Primary

Addresses

Primary practice location

4845 167TH St
Oak Forest, IL 60452-4507

Mailing address

4845 167TH St
Oak Forest, IL 60452-4507
Phone (708) 247-5818

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20260506002415 IL Part B Supplier - Clinic/Group Practice 2062980295 Receives reassigned benefits from 1 practitioner
Practice locations: Oak Forest, IL

National Provider Directory

National Provider Directory

Locations

4845 167th St
Oak Forest, IL 60452
Phone (708) 247-5818

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1774224000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1785715200000",
    "number": "1447198452",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4845 167TH ST",
            "city": "OAK FOREST",
            "state": "IL",
            "postal_code": "604524507",
            "telephone_number": "708-247-5818"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4845 167TH ST",
            "city": "OAK FOREST",
            "state": "IL",
            "postal_code": "604524507",
            "telephone_number": "708-247-5818"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SECURE ROOTS THERAPY PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2026-03-23",
        "last_updated": "2026-08-03",
        "certification_date": "2026-08-03",
        "status": "A",
        "authorized_official_last_name": "LUCAS",
        "authorized_official_first_name": "KAYLA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "708-247-5818",
        "authorized_official_credential": "LCPC"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Oak Forest, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 3, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.