Active NPI
Nicole J Kwon, MA, LPC
- Mental Health Counselor
- Schaumburg, IL
National Provider Identifier
1477310738
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Mental Health Counselor
- License
- 178.019982
- Practice address
- 1015 W Wise Rd Ste 201
Schaumburg, IL 60193-3777 - Phone
- (224) 707-1015
- NPI assigned
- Mar 4, 2024
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | 178.019982 | IL | Primary |
Addresses
Primary practice location
1015 W Wise Rd Ste 201
Schaumburg, IL 60193-3777
Mailing address
2025 Prentiss Dr # B207
Downers Grove, IL 60516-2375
Phone (630) 880-2498
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
- Credentials
- Master of Arts
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 178.019982 | IL | MD | Mental Health Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1709510400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1709510400000",
"number": "1477310738",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2025 PRENTISS DR # B207",
"city": "DOWNERS GROVE",
"state": "IL",
"postal_code": "605162375",
"telephone_number": "630-880-2498"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1015 W WISE RD STE 201",
"city": "SCHAUMBURG",
"state": "IL",
"postal_code": "601933777",
"telephone_number": "224-707-1015"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KWON",
"first_name": "NICOLE",
"middle_name": "J",
"credential": "MA, LPC",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2024-03-04",
"last_updated": "2024-03-04",
"certification_date": "2024-03-04",
"status": "A"
},
"taxonomies": [
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": "IL",
"license": "178.019982",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Schaumburg, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 4, 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.