Israel Illingworth, MA, LPC

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

Practice address

2245 S State St
Ann Arbor, MI 48104-6184

Phone

(734) 769-0209

NPI assigned

Jan 10, 2023

Last updated

Jan 10, 2023By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in MI

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Mental Health Counselor

Education

Other, 2020

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Jewish Family Services of Washtenaw County IncGroup PAC ID 2769671106, 8 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Master of Arts

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Jewish Family Services of Washtenaw County, Inc.

  • Mental Health Counselor
  • Ann Arbor, MI
  • NPI 1558691162
  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1673308800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1673308800000",
    "number": "1447964887",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1060 WIARD RD",
            "city": "YPSILANTI",
            "state": "MI",
            "postal_code": "481984235"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2245 S STATE ST",
            "city": "ANN ARBOR",
            "state": "MI",
            "postal_code": "481046184",
            "telephone_number": "734-769-0209"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ILLINGWORTH",
        "first_name": "ISRAEL",
        "credential": "MA, LPC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2023-01-10",
        "last_updated": "2023-01-10",
        "certification_date": "2023-01-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Robert William Ike, MD
• Lyna Ikharbine
• Jennifer Marie Ilacqua, MSN, ACNP-BC
• Anne-Marie M Ilgen, MSW
• Mark Andrew Ilgen, PHD
• Kelley Lynn Illis, RN
• Kristi Illis, RN
• Illumination Psychotherapy, PLLC
• David Soon Im, MD
• Masami Imai, CNIM

• Mental Health Counselor in Ann Arbor, MI
• Providers in Ann Arbor, MI by specialty
• Mental Health Counselor in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 10, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.