Individual provider Active NPI

Monimia Yvonne Macbeth, LCPC, R-DMT

  • Professional Counselor
  • Chicago, IL
National Provider Identifier
1457096901
Registry record updated Apr 29, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
180013603 Issued in IL
Practice address
2659 W Division St
Chicago, IL 60622-2851
Phone
(954) 732-4411
NPI assigned
Apr 29, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 29, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Dance Therapist 225600000X
Professional Counselor 101YP2500X 180013603 IL Primary

Addresses

Primary practice location

2659 W Division St
Chicago, IL 60622-2851

Mailing address

1440 E 52ND St Apt 14E
Chicago, IL 60615-4382

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
180013603ILMDProfessional Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Creative Passages PLLC Current Accepting new patients
Fly Radical Therapy, LLC Professional Past Accepting new patients

Locations

3523 N Lincoln Ave
Chicago, IL 60657
Phone (773) 263-3222

Organizations & group practices 2

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": "1651190400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1651190400000",
    "number": "1457096901",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1440 E 52ND ST APT 14E",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606154382"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2659 W DIVISION ST",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606222851",
            "telephone_number": "954-732-4411"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MACBETH",
        "first_name": "MONIMIA",
        "middle_name": "YVONNE",
        "credential": "LCPC, R-DMT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-04-29",
        "last_updated": "2022-04-29",
        "certification_date": "2022-03-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225600000X",
            "taxonomy_group": "",
            "desc": "Dance Therapist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "IL",
            "license": "180013603",
            "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 Apr 29, 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.