Individual provider Active NPI

Andrea Raquel Pina

  • Mental Health Counselor
  • Tinley Park, IL
National Provider Identifier
1467283036
Registry record updated Aug 13, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
Practice address
7851 185TH St Ste 203
Tinley Park, IL 60477-6503
Phone
(708) 963-0333
NPI assigned
Aug 13, 2024
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 13, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X Primary

Addresses

Primary practice location

7851 185TH St Ste 203
Tinley Park, IL 60477-6503

Mailing address

12809 E Playfield Dr
Crestwood, IL 60418-1104

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

Practice roles

OrganizationSpecialtyStatusNew patients
Thriving Lives Counseling, LLC Mental Health CurrentSince Aug 18, 2024 Accepting new patients

Locations

7851 185th St
Ste 203
Tinley Park, IL 60477
Phone (708) 963-0333

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": "1723507200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1723507200000",
    "number": "1467283036",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12809 E PLAYFIELD DR",
            "city": "CRESTWOOD",
            "state": "IL",
            "postal_code": "604181104"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7851 185TH ST STE 203",
            "city": "TINLEY PARK",
            "state": "IL",
            "postal_code": "604776503",
            "telephone_number": "708-963-0333"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PINA",
        "first_name": "ANDREA",
        "middle_name": "RAQUEL",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2024-08-13",
        "last_updated": "2024-08-13",
        "certification_date": "2024-08-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tinley Park, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 13, 2024; 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.