Individual provider Active NPI

Santina Bianco

  • Mental Health Counselor
  • Chicago, IL
National Provider Identifier
1649870643
Registry record updated Nov 12, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
178.016472 Issued in IL
Practice address
3525 W Peterson Ave Ste 522
Chicago, IL 60659-3317
Phone
(312) 781-2850
NPI assigned
Oct 28, 2020
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 12, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health CounselorGroup: 193400000X SINGLE SPECIALTY GROUP 101YM0800X 178.016472 IL Primary

Addresses

Primary practice location

3525 W Peterson Ave Ste 522
Chicago, IL 60659-3317

Mailing address

1260 N Dearborn St Apt 416
Chicago, IL 60610-2240

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
178.016472ILMDMental Health Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Chicago Psych Therapy Group, Inc. Mental Health CurrentSince Nov 1, 2020 Accepting new patients

Locations

3525 W Peterson Ave
Ste 522
Chicago, IL 60659
Phone (312) 781-2850

1603 Orrington Ave
Ste 602
Evanston, IL 60201
Phone (312) 781-2850

1603 Orrington Ave
Evanston, IL 60201
Phone (312) 781-2850

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1603843200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1605139200000",
    "number": "1649870643",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1260 N DEARBORN ST APT 416",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606102240"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3525 W PETERSON AVE STE 522",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606593317",
            "telephone_number": "312-781-2850"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BIANCO",
        "first_name": "SANTINA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-10-28",
        "last_updated": "2020-11-12",
        "certification_date": "2020-11-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Counselor, Mental Health",
            "state": "IL",
            "license": "178.016472",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chicago, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 12, 2020; 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.