Nayesha Adia Pruitt, LPC

Primary specialty

School CounselorTaxonomy code 101YS0200X

License

2355616 Issued in IL

Practice address

2659 W Division St
Chicago, IL 60622-2851

Phone

(312) 859-3675

NPI assigned

Jan 11, 2022

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Fly Radical Therapy, LLC

  • Professional Counselor
  • Chicago, IL
  • NPI 1720745912
  NPD (past)

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

{
    "created_epoch": "1641859200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1641859200000",
    "number": "1508517608",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6224 S DORCHESTER AVE APT 1",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606375184",
            "telephone_number": "312-859-3675"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2659 W DIVISION ST",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606222851",
            "telephone_number": "312-859-3675"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PRUITT",
        "first_name": "NAYESHA",
        "middle_name": "ADIA",
        "name_prefix": "Mrs.",
        "credential": "LPC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-01-11",
        "last_updated": "2022-01-11",
        "certification_date": "2022-01-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "IL",
            "license": "178.016203",
            "primary": false
        },
        {
            "code": "101YS0200X",
            "taxonomy_group": "",
            "desc": "Counselor, School",
            "state": "IL",
            "license": "2355616",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Taylor Pruett, LCSW
• Gladys Pruitt-Lang
• Coretta J Pruitt
• Jamesa Pruitt
• Mignon Pruitt
• Nikiya Pruitt
• Peter Burton Pruitt, M.D.
• Shervylle Pruitt
• Bozena Prus, PA
• Igor Prus, MD

• School Counselor in Chicago, IL
• Providers in Chicago, IL by specialty
• School Counselor in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 11, 2022; 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.