Philomena Bridget Nowak, MS LCPC CRC

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

Practice address

9405 Bormet
Suite 10
Mokena, IL 60448

Phone

(708) 479-8977

Fax

(708) 479-8987

NPI assigned

Aug 6, 2007

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other names 1

• Bridget Nowak Professional name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Science

State licenses

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

{
    "created_epoch": "1186358400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1186358400000",
    "number": "1447441316",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 818",
            "city": "MOKENA",
            "state": "IL",
            "postal_code": "60448",
            "telephone_number": "708-479-8977",
            "fax_number": "708-479-8987"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9405 BORMET",
            "address_2": "SUITE 10",
            "city": "MOKENA",
            "state": "IL",
            "postal_code": "60448",
            "telephone_number": "708-479-8977",
            "fax_number": "708-479-8987"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NOWAK",
        "first_name": "PHILOMENA",
        "middle_name": "BRIDGET",
        "name_prefix": "Mrs.",
        "credential": "MS LCPC CRC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-08-06",
        "last_updated": "2007-08-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225C00000X",
            "taxonomy_group": "",
            "desc": "Rehabilitation Counselor",
            "state": "IL",
            "license": "00005014",
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "IL",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "BRIDGET",
            "last_name": "NOWAK",
            "credential": "MS LCPC CRC",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

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• Professional Counselor in Mokena, IL
• Providers in Mokena, IL by specialty
• Professional Counselor in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 6, 2007; 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.