Individual provider Active NPI

Melissa Guzicki, LCPC

  • Mental Health Counselor
  • Chicago, IL
National Provider Identifier
1609322353
Registry record updated Jan 24, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
180.007892 Issued in IL
Practice address
1520 North Kostn
Near North Health Center -North Kostner
Chicago, IL 60615
Phone
(312) 216-8020
NPI assigned
Aug 31, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 24, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X 180.007892 IL Primary

Addresses

Primary practice location

1520 North Kostn
Near North Health Center -North Kostner
Chicago, IL 60615

Mailing address

1520 N Kostner Ave
Chicago, IL 60651-1610
Phone (312) 216-8020

Other identifiers 1

IdentifierTypeStateIssuer
180.007892MedicaidIL

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL
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
I20240528001700 IL Practitioner - Mental Health Counselor 3577905108 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Primecare Community Health, Inc. Current Accepting new patients
Primecare Community Health Inc CurrentSince Apr 14, 2024 Accepting new patients
Primecare Community Health, Inc. CurrentSince Apr 14, 2024 Accepting new patients

Locations

1431 N Western Ave
Ste 406
Chicago, IL 60622
Phone (312) 491-5495

Organizations & group practices 3

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": "1472601600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1485216000000",
    "number": "1609322353",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1520 N KOSTNER AVE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606511610",
            "telephone_number": "312-216-8020"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1520 NORTH KOSTN",
            "address_2": "NEAR NORTH HEALTH CENTER -NORTH KOSTNER",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "60615",
            "telephone_number": "312-216-8020"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GUZICKI",
        "first_name": "MELISSA",
        "name_prefix": "Ms.",
        "credential": "LCPC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-08-31",
        "last_updated": "2017-01-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "IL",
            "license": "180.007892",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "180.007892",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Chicago, IL

Sources for this page

Verify at the official NPI Registry.