Individual provider Active NPI

Tanisha Horne

  • Professional Counselor
  • Oak Brook, IL
National Provider Identifier
1538712294
Registry record updated Oct 1, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
178011997 Issued in IL
Practice address
1010 Jorie Blvd Ste 112
Oak Brook, IL 60523-4446
Phone
(224) 325-4513
NPI assigned
Jul 22, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 1, 2020

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 178011997 IL Primary

Addresses

Primary practice location

1010 Jorie Blvd Ste 112
Oak Brook, IL 60523-4446

Mailing address

123 E Lake St Ste 201
Bloomingdale, IL 60108-1100
Phone (224) 325-4513

Other practice location 1

134 W Lake St # 6
Bloomingdale, IL 60108-1020
Phone (224) 325-4513

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IN
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.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240301000333 IN Practitioner - Mental Health Counselor 0840635702 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
178011997ILMDProfessional Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Freedome Counseling,LLC Professional CurrentSince May 26, 2024 Accepting new patients

Locations

1116 Hoffman St
Hammond, IN 46327
Phone (773) 701-3520

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1563753600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1601510400000",
    "number": "1538712294",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "123 E LAKE ST STE 201",
            "city": "BLOOMINGDALE",
            "state": "IL",
            "postal_code": "601081100",
            "telephone_number": "224-325-4513"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1010 JORIE BLVD STE 112",
            "city": "OAK BROOK",
            "state": "IL",
            "postal_code": "605234446",
            "telephone_number": "224-325-4513"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "134 W Lake St # 6",
            "address_purpose": "LOCATION",
            "city": "Bloomingdale",
            "state": "IL",
            "postal_code": "601081020",
            "country_code": "US",
            "telephone_number": "224-325-4513",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HORNE",
        "first_name": "TANISHA",
        "name_prefix": "Mrs.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-07-22",
        "last_updated": "2020-10-01",
        "certification_date": "2020-10-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "IL",
            "license": "178011997",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Oak Brook, IL

Sources for this page

Verify at the official NPI Registry.