Individual provider Active NPI

Dorothy Kuklinski, M.A., LPC

  • Professional Counselor
  • Hazel Crest, IL
National Provider Identifier
1487199089
Registry record updated Jan 5, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
178.012610 Issued in IL
Practice address
17577 Kedzie Ave
Hazel Crest, IL 60429-2051
Phone
(708) 250-0520
NPI assigned
Jan 5, 2017
Last updated
Jan 5, 2017By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 5, 2017

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 178.012610 IL Primary

Addresses

Primary practice location

17577 Kedzie Ave
Hazel Crest, IL 60429-2051

Mailing address

10985 S 84TH Ave
Apt 2a
Palos Hills, IL 60465-3231
Phone (708) 717-4461

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

LicenseStateTypeSpecialty
178.012610ILMDProfessional Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Harvey Martin & Associates Inc. Past Accepting new patients

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, 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": "1483574400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1483574400000",
    "number": "1487199089",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10985 S 84TH AVE",
            "address_2": "APT 2A",
            "city": "PALOS HILLS",
            "state": "IL",
            "postal_code": "604653231",
            "telephone_number": "708-717-4461"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17577 KEDZIE AVE",
            "city": "HAZEL CREST",
            "state": "IL",
            "postal_code": "604292051",
            "telephone_number": "708-250-0520"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KUKLINSKI",
        "first_name": "DOROTHY",
        "credential": "M.A., LPC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-01-05",
        "last_updated": "2017-01-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "IL",
            "license": "178.012610",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hazel Crest, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 5, 2017; 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.