Active NPI
Emma Bulzoni, LPC
- Mental Health Counselor
- Chicago, IL
National Provider Identifier
1669007647
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Mental Health Counselor
- License
- 178.014640
- Practice address
- 405 N Wabash Ave Unit 3209
Chicago, IL 60611-5675 - Phone
- (312) 467-0000
- NPI assigned
- Mar 10, 2020
- 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 |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | 178.014640 | IL | Primary |
Addresses
Primary practice location
405 N Wabash Ave Unit 3209
Chicago, IL 60611-5675
Mailing address
3842 N Damen Ave Apt 2
Chicago, IL 60618-3991
Phone (847) 903-1051
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| SOAP URL | https://www.psychselect.com/cgi-bin/TAC7-0/login/TherapistLogin.cfm |
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
| License | State | Type | Specialty |
|---|---|---|---|
| 178.014640 | IL | MD | Mental Health Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1583798400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1583798400000",
"number": "1669007647",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3842 N DAMEN AVE APT 2",
"city": "CHICAGO",
"state": "IL",
"postal_code": "606183991",
"telephone_number": "847-903-1051"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "405 N WABASH AVE UNIT 3209",
"city": "CHICAGO",
"state": "IL",
"postal_code": "606115675",
"telephone_number": "312-467-0000"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BULZONI",
"first_name": "EMMA",
"credential": "LPC",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2020-03-10",
"last_updated": "2020-03-10",
"certification_date": "2020-03-10",
"status": "A"
},
"taxonomies": [
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": "IL",
"license": "178.014640",
"primary": true
}
],
"identifiers": [],
"endpoints": [
{
"endpointType": "SOAP",
"endpointTypeDescription": "SOAP URL",
"endpoint": "https://www.psychselect.com/cgi-bin/TAC7-0/login/TherapistLogin.cfm",
"affiliation": "N",
"endpointDescription": "Therapy appointment",
"address_1": "405 N Wabash Ave Unit 3209",
"city": "Chicago",
"state": "IL",
"country_code": "US",
"postal_code": "606115675",
"country_name": "United States",
"address_type": "DOM"
}
],
"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 Mar 10, 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.