NPIMap

Organization Active NPI

Associates in Professional Counseling Charles R Polcaster PHD PC

  • Professional Counselor
  • Palos Heights, IL
National Provider Identifier
1619047297
Registry record updated Mar 11, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
060008046 Issued in IL
Legal business name
ASSOCIATES IN PROFESSIONAL COUNSELING CHARLES R POLCASTER PHD PC
Practice address
7804 W College Dr
2NE
Palos Heights, IL 60463-1025
Phone
(708) 448-0884
Fax
(708) 448-0594
NPI assigned
Nov 9, 2006
Last updated
Mar 11, 2014By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 11, 2014

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

Authorized official

Name
Charles R Polcaster, PHDNPI 1811067408
Title
President - Clinical Director
Phone
(708) 448-0884

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Professional Counselor 101YP2500X 060008046 IL Primary

Addresses

Primary practice location

7804 W College Dr
2NE
Palos Heights, IL 60463-1025

Mailing address

7804 W College Dr
2NE
Palos Heights, IL 60463-1025
Phone (708) 448-0884

Other identifiers 1

IdentifierTypeStateIssuer
01632157OtherILBLUE CROSS BLUE SHIELD

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1163030400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1394496000000",
    "number": "1619047297",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7804 W COLLEGE DR",
            "address_2": "2NE",
            "city": "PALOS HEIGHTS",
            "state": "IL",
            "postal_code": "604631025",
            "telephone_number": "708-448-0884",
            "fax_number": "708-448-0594"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7804 W COLLEGE DR",
            "address_2": "2NE",
            "city": "PALOS HEIGHTS",
            "state": "IL",
            "postal_code": "604631025",
            "telephone_number": "708-448-0884",
            "fax_number": "708-448-0594"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ASSOCIATES IN PROFESSIONAL COUNSELING CHARLES R POLCASTER PHD PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-09",
        "last_updated": "2014-03-11",
        "status": "A",
        "authorized_official_last_name": "POLCASTER",
        "authorized_official_first_name": "CHARLES",
        "authorized_official_middle_name": "R",
        "authorized_official_title_or_position": "PRESIDENT - CLINICAL DIRECTOR",
        "authorized_official_telephone_number": "708-448-0884",
        "authorized_official_credential": "PHD"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "IL",
            "license": "060008046",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "01632157",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Palos Heights, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 11, 2014; 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.