Organization Active NPI

Anita Mandley LCPC PLLC

  • Adult Mental Health Clinic/Center
  • Skokie, IL
National Provider Identifier
1619628450
Registry record updated Jan 13, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Mental Health Clinic/CenterTaxonomy code 261QM0850X
Legal business name
ANITA MANDLEY LCPC PLLC
Practice address
7514 Kostner Ave
Skokie, IL 60076-3828
Phone
(312) 509-2245
NPI assigned
Jan 13, 2022
Last updated
Jan 13, 2022By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 13, 2022

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

Authorized official

Name
Anita A Mandley, LCPCNPI 1609956077
Title
Owner
Phone
(312) 509-2245

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
Adult Mental Health Clinic/Center 261QM0850X Primary

Addresses

Primary practice location

7514 Kostner Ave
Skokie, IL 60076-3828

Mailing address

7514 Kostner Ave
Skokie, IL 60076-3828
Phone (312) 509-2245

Other identifiers 1

IdentifierTypeStateIssuer
180002457OtherILCLINICAL COUNSELORPROFESSIONAL LICENSE

Electronic endpoints 1

TypeEndpointUseAffiliation
CONNECT URL amamandley@anita-mandley.com Direct

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

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": "1642032000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1642032000000",
    "number": "1619628450",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7514 KOSTNER AVE",
            "city": "SKOKIE",
            "state": "IL",
            "postal_code": "600763828",
            "telephone_number": "312-509-2245"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7514 KOSTNER AVE",
            "city": "SKOKIE",
            "state": "IL",
            "postal_code": "600763828",
            "telephone_number": "312-509-2245"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ANITA MANDLEY LCPC PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-01-13",
        "last_updated": "2022-01-13",
        "certification_date": "2022-01-13",
        "status": "A",
        "authorized_official_last_name": "MANDLEY",
        "authorized_official_first_name": "ANITA",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "312-509-2245",
        "authorized_official_credential": "LCPC"
    },
    "taxonomies": [
        {
            "code": "261QM0850X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adult Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CLINICAL COUNSELORPROFESSIONAL LICENSE",
            "identifier": "180002457",
            "state": "IL"
        }
    ],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "amamandley@anita-mandley.com",
            "affiliation": "N",
            "endpointDescription": "website and email address",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "7514 Kostner Ave",
            "city": "Skokie",
            "state": "IL",
            "country_code": "US",
            "postal_code": "600763828",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Skokie, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 13, 2022; 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.