Active NPI
Larcetta Linear
- Professional Counselor
- Park Forest, IL
National Provider Identifier
1659959559
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Professional Counselor
- License
- 180.011430
- Practice address
- 20 Dogwood St
Park Forest, IL 60466-1821 - Phone
- (708) 747-2507
- NPI assigned
- Mar 31, 2021
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Professional Counselor | 101YP2500X | 180.011430 | IL | Primary |
Addresses
Primary practice location
20 Dogwood St
Park Forest, IL 60466-1821
Mailing address
20 Dogwood St
Park Forest, IL 60466-1821
Phone (708) 747-2507
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in IL
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: No
- Power mobility devices: No
- Hospice: No
Enrollment records 1
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 180.011430 | IL | MD | Professional Counselor |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Brightside Medical, P.a. | Current | Accepting new patients | |
| Brightside Medical of Michigan PC | Past | Accepting new patients |
Locations
2261 Market St
San Francisco, CA 94114
Phone (213) 337-4615
1440 W Taylor St
Chicago, IL 60607
Phone (612) 263-9334
Organizations & group practices 2
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.
-
- Psychiatry Physician
- San Francisco, CA
- NPI 1144800350
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1617148800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1617148800000",
"number": "1659959559",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "20 DOGWOOD ST",
"city": "PARK FOREST",
"state": "IL",
"postal_code": "604661821",
"telephone_number": "708-747-2507"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "20 DOGWOOD ST",
"city": "PARK FOREST",
"state": "IL",
"postal_code": "604661821",
"telephone_number": "708-747-2507"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LINEAR",
"first_name": "LARCETTA",
"name_prefix": "Ms.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2021-03-31",
"last_updated": "2021-03-31",
"certification_date": "2021-03-31",
"status": "A"
},
"taxonomies": [
{
"code": "101YP2500X",
"taxonomy_group": "",
"desc": "Counselor, Professional",
"state": "IL",
"license": "180.011430",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Park Forest, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 31, 2021; 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.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.