Kenneth A Gleaves, PH.D., LCPC, NCACI

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

180001207 Issued in IL

Practice address

3450 W Maple St RM 200
Evergreen Park, IL 60805-3043

Phone

(708) 422-2885

Fax

(708) 422-7161

NPI assigned

Aug 29, 2006

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Philosophy

State licenses

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

{
    "created_epoch": "1156809600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1750377600000",
    "number": "1609984764",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3450 W MAPLE ST RM 200",
            "city": "EVERGREEN PARK",
            "state": "IL",
            "postal_code": "608053043",
            "telephone_number": "708-422-2885",
            "fax_number": "708-422-7161"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3450 W MAPLE ST RM 200",
            "city": "EVERGREEN PARK",
            "state": "IL",
            "postal_code": "608053043",
            "telephone_number": "708-422-2885",
            "fax_number": "708-422-7161"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GLEAVES",
        "first_name": "KENNETH",
        "middle_name": "A",
        "name_prefix": "Dr.",
        "credential": "PH.D., LCPC, NCACI",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-08-29",
        "last_updated": "2025-06-20",
        "certification_date": "2025-06-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "IL",
            "license": "2812",
            "primary": false
        },
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "VA",
            "license": "006460",
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "IL",
            "license": "180001207",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Gerald a Cahill MD SC
• Georgianne M Gerber, LCSW
• Sierra Gibson, LCPC
• Jennifer Gilhooly
• Kevin Patrick Gillespie, CRNA
• Nancy L Gleaves, MA, LCPC, NCAC II
• Matthew John Glowacki, D.O.
• Brian C. Gold, LCSW
• Jared Gonzales
• Kendra Taylor Gorny

• Professional Counselor in Evergreen Park, IL
• Providers in Evergreen Park, IL by specialty
• Professional Counselor in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 20, 2025; 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.