Organization Active NPI

Peacefully Adjacent Therapy & Wellness PLLC

  • Mental Health Counselor
  • Olympia Fields, IL
National Provider Identifier
1639987258
Registry record updated Dec 28, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
Legal business name
PEACEFULLY ADJACENT THERAPY & WELLNESS PLLC
Practice address
20303 S. Crawford Ave
Unit 210
Olympia Fields, IL 60461
Phone
(708) 549-9046
NPI assigned
Dec 28, 2024
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 28, 2024

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

Authorized official

Name
Sieda J Hill, LCSWNPI 1326553694
Title
Owner/Manager
Phone
(773) 428-7466

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
Mental Health CounselorGroup: 193200000X MULTI-SPECIALTY GROUP 101YM0800X Primary

Addresses

Primary practice location

20303 S. Crawford Ave
Unit 210
Olympia Fields, IL 60461

Mailing address

6811 167TH St RM 4
Tinley Park, IL 60477-2501

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20250422000378 IL Part B Supplier - Clinic/Group Practice 8729503875 Receives reassigned benefits from 1 practitioner
Practice locations: Olympia Fields, IL

National Provider Directory

National Provider Directory

Locations

6811 167th St
Rm 4
Tinley Park, IL 60477

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1735344000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1735344000000",
    "number": "1639987258",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6811 167TH ST RM 4",
            "city": "TINLEY PARK",
            "state": "IL",
            "postal_code": "604772501"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "20303 S. CRAWFORD AVE",
            "address_2": "UNIT 210",
            "city": "OLYMPIA FIELDS",
            "state": "IL",
            "postal_code": "60461",
            "telephone_number": "708-549-9046"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PEACEFULLY ADJACENT THERAPY & WELLNESS PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-12-28",
        "last_updated": "2024-12-28",
        "certification_date": "2024-12-28",
        "status": "A",
        "authorized_official_last_name": "HILL",
        "authorized_official_first_name": "SIEDA",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "OWNER/MANAGER",
        "authorized_official_telephone_number": "773-428-7466",
        "authorized_official_credential": "LCSW"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Olympia Fields, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 28, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.