Active NPI
Kenneth D Richmond
- Mental Health Counselor
- Chicago, IL
National Provider Identifier
1558101048
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Mental Health Counselor
- License
- 150111927
- Practice address
- 1507 N Milwaukee Ave Apt 3
Chicago, IL 60622-2009 - Phone
- (773) 386-6510
- NPI assigned
- May 31, 2024
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | 150111927 | IL | Primary |
Addresses
Primary practice location
1507 N Milwaukee Ave Apt 3
Chicago, IL 60622-2009
Mailing address
1922 S Troy St Apt 2
Chicago, IL 60623-2294
Phone (646) 276-4825
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
| License | State | Type | Specialty |
|---|---|---|---|
| 150111927 | IL | MD | Mental Health Counselor |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Soma Counseling Center, PLLC | Mental Health | Current | Accepting new patients |
Locations
1507 N Milwaukee Ave
Apt 3
Chicago, IL 60622
Phone (646) 276-4825
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 and National Provider Directory roles.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1717113600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1717113600000",
"number": "1558101048",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1922 S TROY ST APT 2",
"city": "CHICAGO",
"state": "IL",
"postal_code": "606232294",
"telephone_number": "646-276-4825"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1507 N MILWAUKEE AVE APT 3",
"city": "CHICAGO",
"state": "IL",
"postal_code": "606222009",
"telephone_number": "773-386-6510"
}
],
"practiceLocations": [],
"basic": {
"last_name": "RICHMOND",
"first_name": "KENNETH",
"middle_name": "D",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2024-05-31",
"last_updated": "2024-05-31",
"certification_date": "2024-05-30",
"status": "A"
},
"taxonomies": [
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": "IL",
"license": "150111927",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Chicago, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 31, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.