Individual provider Active NPI

Megan Elizabeth Riesgo, LCPC

  • Professional Counselor
  • Lombard, IL
National Provider Identifier
1659712925
Registry record updated Jun 23, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
180.014487 Issued in IL
Practice address
477 E Butterfield Rd Ste 212
Lombard, IL 60148-4879
Phone
(630) 866-5666
Fax
(630) 358-6907
NPI assigned
Jul 15, 2013
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 23, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Professional CounselorGroup: 193200000X MULTI-SPECIALTY GROUP 101YP2500X 180.014487 IL Primary

Addresses

Primary practice location

477 E Butterfield Rd Ste 212
Lombard, IL 60148-4879

Mailing address

477 E Butterfield Rd Ste 212
Lombard, IL 60148-4879
Phone (630) 866-5666

Other practice location 1

6918 Windsor Ave
Berwyn, IL 60402-3334
Phone (708) 745-5277

Other names 1

  • Megan Eyrich Former name

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
180.014487ILMDProfessional Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Bricolage Wellness, LLC CurrentSince Jun 26, 2022 Accepting new patients

Locations

477 E Butterfield Rd
Ste 212
Lombard, IL 60148
Phone (630) 335-4209

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": "1373846400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1655942400000",
    "number": "1659712925",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "477 E BUTTERFIELD RD STE 212",
            "city": "LOMBARD",
            "state": "IL",
            "postal_code": "601484879",
            "telephone_number": "630-866-5666",
            "fax_number": "630-358-6907"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "477 E BUTTERFIELD RD STE 212",
            "city": "LOMBARD",
            "state": "IL",
            "postal_code": "601484879",
            "telephone_number": "630-866-5666",
            "fax_number": "630-358-6907"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "6918 Windsor Ave",
            "address_purpose": "LOCATION",
            "city": "Berwyn",
            "state": "IL",
            "postal_code": "604023334",
            "country_code": "US",
            "telephone_number": "708-745-5277",
            "fax_number": "708-795-4834",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "RIESGO",
        "first_name": "MEGAN",
        "middle_name": "ELIZABETH",
        "credential": "LCPC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2013-07-15",
        "last_updated": "2022-06-23",
        "certification_date": "2022-06-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Professional",
            "state": "IL",
            "license": "180.014487",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MEGAN",
            "last_name": "EYRICH",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Lombard, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 23, 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.