Individual provider Active NPI

Rachel Diane Harden-Maddox, LCPC, CADC

  • Professional Counselor
  • Flossmoor, IL
National Provider Identifier
1457967887
Registry record updated Oct 10, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
178016214 Issued in IL
Practice address
2946 Carmel Dr
Flossmoor, IL 60422-2284
Phone
(708) 953-9355
NPI assigned
Sep 21, 2020
Last updated
Oct 10, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 10, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X 180014989 IL
Professional Counselor 101YP2500X 178016214 IL Primary

Addresses

Primary practice location

2946 Carmel Dr
Flossmoor, IL 60422-2284

Mailing address

20015 S Lagrange Rd # 1269
Frankfort, IL 60423-3104
Phone (708) 953-9355

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL
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

Enrollment IDStateProvider typePAC IDDetails
I20240805000881 IL Practitioner - Mental Health Counselor 5395282842

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
180014989ILMDMental Health Counselor
178016214ILMDProfessional Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Wellness Couch Therapeutic Spa & Treatment Center Mental Health CurrentSince Jan 1, 2023 Accepting new patients
The Wellness Couch Mental Health CurrentSince Jul 22, 2024 Accepting new patients
Accepting LLC Mental Health PastSince Sep 1, 2020 Accepting new patients

Locations

4610 N Clark St
Chicago, IL 60640
Phone (312) 970-1787

20015 S Lagrange Rd
Frankfort, IL 60423
Phone (708) 554-3917

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1600646400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1696896000000",
    "number": "1457967887",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "20015 S LAGRANGE RD # 1269",
            "city": "FRANKFORT",
            "state": "IL",
            "postal_code": "604233104",
            "telephone_number": "708-953-9355"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2946 CARMEL DR",
            "city": "FLOSSMOOR",
            "state": "IL",
            "postal_code": "604222284",
            "telephone_number": "708-953-9355"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HARDEN-MADDOX",
        "first_name": "RACHEL",
        "middle_name": "DIANE",
        "credential": "LCPC, CADC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-09-21",
        "last_updated": "2023-10-10",
        "certification_date": "2023-10-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "IL",
            "license": "180014989",
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "IL",
            "license": "178016214",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Flossmoor, IL

Sources for this page

Verify at the official NPI Registry.