Individual provider Active NPI

Stephanie Keeshin, LPC

  • Professional Counselor
  • Chicago, IL
National Provider Identifier
1477124022
Registry record updated Jul 6, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
178.017006 Issued in IL
Practice address
405 N Wabash Ave Unit 1114
Chicago, IL 60611-3597
Phone
(773) 295-4670
NPI assigned
Jul 6, 2021
Last updated
Jul 6, 2021By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 6, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Professional Counselor 101YP2500X 178.017006 IL Primary

Addresses

Primary practice location

405 N Wabash Ave Unit 1114
Chicago, IL 60611-3597

Mailing address

575 Groveland Ave
Highland Park, IL 60035-5067
Phone (847) 525-5212

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
178.017006ILMDProfessional Counselor

NPI Registry JSON

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

{
    "created_epoch": "1625529600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1625529600000",
    "number": "1477124022",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "575 GROVELAND AVE",
            "city": "HIGHLAND PARK",
            "state": "IL",
            "postal_code": "600355067",
            "telephone_number": "847-525-5212"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "405 N WABASH AVE UNIT 1114",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606113597",
            "telephone_number": "773-295-4670"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KEESHIN",
        "first_name": "STEPHANIE",
        "credential": "LPC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-07-06",
        "last_updated": "2021-07-06",
        "certification_date": "2021-07-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "IL",
            "license": "178.017006",
            "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 Jul 6, 2021; 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.