Individual provider Active NPI

Whitley Tayler Terrell, LPC

  • Counselor
  • Wheaton, IL
National Provider Identifier
1477326726
Registry record updated Oct 30, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
CounselorTaxonomy code 101Y00000X
License
178019494 Issued in IL
Practice address
620 W Roosevelt Rd Ste C1
Wheaton, IL 60187-2306
Phone
(630) 995-3193
NPI assigned
Oct 30, 2023
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 30, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Counselor 101Y00000X 178019494 IL Primary

Addresses

Primary practice location

620 W Roosevelt Rd Ste C1
Wheaton, IL 60187-2306

Mailing address

1754 N Washington St Ste 104a
Naperville, IL 60563-1462
Phone (630) 995-3193

Other practice location 1

1754 N Washington St Ste 104A
Naperville, IL 60563-1462
Phone (630) 995-3193

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
178019494ILMDCounselor

NPI Registry JSON

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

{
    "created_epoch": "1698624000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1698624000000",
    "number": "1477326726",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1754 N WASHINGTON ST STE 104A",
            "city": "NAPERVILLE",
            "state": "IL",
            "postal_code": "605631462",
            "telephone_number": "630-995-3193"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "620 W ROOSEVELT RD STE C1",
            "city": "WHEATON",
            "state": "IL",
            "postal_code": "601872306",
            "telephone_number": "630-995-3193"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1754 N Washington St Ste 104A",
            "address_purpose": "LOCATION",
            "city": "Naperville",
            "state": "IL",
            "postal_code": "605631462",
            "country_code": "US",
            "telephone_number": "630-995-3193",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "TERRELL",
        "first_name": "WHITLEY",
        "middle_name": "TAYLER",
        "credential": "LPC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-10-30",
        "last_updated": "2023-10-30",
        "certification_date": "2023-10-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": "IL",
            "license": "178019494",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Wheaton, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 30, 2023; 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.