Individual provider Active NPI

Yekaterina Shcherbakova, LCPC

  • Professional Counselor
  • Oak Park, IL
National Provider Identifier
1609418607
Registry record updated Feb 25, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
180011350 Issued in IL
Practice address
345 Madison St
Oak Park, IL 60302-4111
Phone
(708) 386-2157
NPI assigned
Oct 10, 2019
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 25, 2022

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X 180011350 IL
Professional Counselor 101YP2500X 1800011350 IL
Professional Counselor 101YP2500X 180011350 IL Primary

Addresses

Primary practice location

345 Madison St
Oak Park, IL 60302-4111

Mailing address

345 Madison St
Oak Park, IL 60302-4111
Phone (708) 386-2157

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
I20240226000145 IL Practitioner - Mental Health Counselor 1153766530

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
1800011350ILMDProfessional Counselor
180011350ILMDProfessional Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Livindi Medical Group Illinois PLLC CurrentSince Jan 1, 2024 Accepting new patients
Livindi Medical Group Illinois PLLC CurrentSince Jan 1, 2024 Accepting new patients

Locations

1328 Main St
Crete, IL 60417
Phone (508) 416-6030

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": "1570665600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1645747200000",
    "number": "1609418607",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "345 MADISON ST",
            "city": "OAK PARK",
            "state": "IL",
            "postal_code": "603024111",
            "telephone_number": "708-386-2157"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "345 MADISON ST",
            "city": "OAK PARK",
            "state": "IL",
            "postal_code": "603024111",
            "telephone_number": "708-386-2157"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHCHERBAKOVA",
        "first_name": "YEKATERINA",
        "credential": "LCPC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-10-10",
        "last_updated": "2022-02-25",
        "certification_date": "2022-02-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "IL",
            "license": "180011350",
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "IL",
            "license": "1800011350",
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "IL",
            "license": "180011350",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Oak Park, IL

Sources for this page

Verify at the official NPI Registry.