Katherine Jane Ford, LCPC

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

180008034 Issued in IL

Practice address

265 Stebbings CT Ste 1
Bradley, IL 60915-1282

Phone

(815) 200-8653

NPI assigned

Mar 19, 2024

Last updated

Mar 19, 2024By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other names 1

• Katherine Jane Ondersma Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

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.

Specialty

Mental Health Counselor

Education

Other, 2006

Medicare assignment

May accept Medicare assignment

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1710806400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1710806400000",
    "number": "1629838701",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1018 S POPLAR AVE",
            "city": "KANKAKEE",
            "state": "IL",
            "postal_code": "609015556",
            "telephone_number": "815-263-0679"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "265 STEBBINGS CT STE 1",
            "city": "BRADLEY",
            "state": "IL",
            "postal_code": "609151282",
            "telephone_number": "815-200-8653"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FORD",
        "first_name": "KATHERINE",
        "middle_name": "JANE",
        "credential": "LCPC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2024-03-19",
        "last_updated": "2024-03-19",
        "certification_date": "2024-03-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "IL",
            "license": "180008034",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KATHERINE",
            "last_name": "ONDERSMA",
            "middle_name": "JANE",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Brittany Nikkole Edwards
• Kaase Gayl El-Talabani
• Amirreza Fallahi, DO
• Parmis Fatih, MD
• Kristin L Fields, PA-C
• Mary Ann Salera Garcia, PT
• Rosaura Garcia, FNP-BC
• Olivia Garrett
• Kristin Brianne Geary, ED.S.
• Jonathan Robert Gilliand

• Professional Counselor in Bradley, IL
• Providers in Bradley, IL by specialty
• Professional Counselor in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 19, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.