Individual provider Active NPI

Matthew Vincent Malicki, LPC

  • Professional Counselor
  • Schaumburg, IL
National Provider Identifier
1487547584
Registry record updated May 29, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
178.021664 Issued in IL
Practice address
715 E Golf Rd Ste 200A1
Schaumburg, IL 60173-4595
Phone
(847) 737-9191
NPI assigned
May 29, 2025
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 29, 2025

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 178.021664 IL Primary

Addresses

Primary practice location

715 E Golf Rd Ste 200A1
Schaumburg, IL 60173-4595

Mailing address

715 E Golf Rd Ste 200A1
Schaumburg, IL 60173-4595
Phone (847) 737-9191

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
178.021664ILMDProfessional Counselor

NPI Registry JSON

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

{
    "created_epoch": "1748476800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1748476800000",
    "number": "1487547584",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "715 E GOLF RD STE 200A1",
            "city": "SCHAUMBURG",
            "state": "IL",
            "postal_code": "601734595",
            "telephone_number": "847-737-9191"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "715 E GOLF RD STE 200A1",
            "city": "SCHAUMBURG",
            "state": "IL",
            "postal_code": "601734595",
            "telephone_number": "847-737-9191"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MALICKI",
        "first_name": "MATTHEW",
        "middle_name": "VINCENT",
        "credential": "LPC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2025-05-29",
        "last_updated": "2025-05-29",
        "certification_date": "2025-05-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "IL",
            "license": "178.021664",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Schaumburg, IL

Sources for this page

Verify at the official NPI Registry.