Sidia Nayeli Diaz de Bernt I, M.A
Individual provider Active NPI Mental Health Counselor · Forest Park, IL
NPI 1457868366 · NPPES record last updated Jan 2, 2018
Key facts
- NPI
- 1457868366
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Mental Health Counselor 101YM0800X
- Practice address
- 1042 Troost Ave
Forest Park, IL 60130-2157 - Phone
- (708) 567-3236
- NPI assigned
- Jan 2, 2018
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 1
Medicare Care Compare profile
- Specialty
- Mental Health Counselor
- Education
- Other, 2015
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Innovative Counseling Partners LLC
Practice addresses (Care Compare)
715 Lake St
Suite 273
Oak Park, IL 60301-1411
Phone (773) 312-3612
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in IL
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: No · Power mobility devices: No · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20240228003021 | IL | Practitioner - Mental Health Counselor | 0345685434 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Master of Arts
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Innovative Counseling Partners LLC | Current |
Accepting new patients |
Locations
715 Lake St
Ste 273
Oak Park, IL 60301
Phone (708) 848-3800
7222 W Cermak Rd
Ste 703
Riverside, IL 60546
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | Yes |
Addresses
Primary practice location
1042 Troost Ave
Forest Park, IL 60130-2157
Mailing address
1042 Troost Ave
Forest Park, IL 60130-2157
Phone (708) 567-3236
Other providers in Forest Park, IL
- Rachel Dennis
- Kathryn Deraedt
- Nancy Jeanne Derrig
- Raj Desai
- Diana Alejandro, LCSW, LLC
- Chantal Diprima
- Dianella V Dizon-Menezes
- Sandy Doan
- Dajah Dobbs
- Philip Andrew Doherty
All providers in Forest Park, IL · Mental Health Counselor in Illinois
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jan 2, 2018. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.