Individual provider Active NPI

Ryan Coventry, M.A.

  • Counselor
  • Chicago, IL
National Provider Identifier
1447604285
Registry record updated Feb 15, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
CounselorTaxonomy code 101Y00000X
License
178.011581 Issued in IL
Practice address
5340 N Clark St
Suite 212
Chicago, IL 60640-2120
Phone
(312) 600-5491
NPI assigned
Apr 18, 2016
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 15, 2023

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X 180.011972 IL
Mental Health Counselor 101YM0800X 178.011581 IL
Professional Counselor 101YP2500X 180.011972 IL
Counselor 101Y00000X 178.011581 IL Primary

Addresses

Primary practice location

5340 N Clark St
Suite 212
Chicago, IL 60640-2120

Mailing address

4610 N Clark St # 1037
Chicago, IL 60640-4620
Phone (312) 741-3320

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
Credentials
Master of Arts

State licenses

LicenseStateTypeSpecialty
178.011581ILMDCounselor
180.011972ILMDProfessional Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Coventry Counseling 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": "1460937600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1676419200000",
    "number": "1447604285",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4610 N CLARK ST # 1037",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606404620",
            "telephone_number": "312-741-3320"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5340 N CLARK ST",
            "address_2": "SUITE 212",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606402120",
            "telephone_number": "312-600-5491"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COVENTRY",
        "first_name": "RYAN",
        "credential": "M.A.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-04-18",
        "last_updated": "2023-02-15",
        "certification_date": "2023-02-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "IL",
            "license": "180.011972",
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "IL",
            "license": "178.011581",
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "IL",
            "license": "180.011972",
            "primary": false
        },
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": "IL",
            "license": "178.011581",
            "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 Feb 15, 2023; 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.