Active NPI
Elisha Hamilton, LCPC
- Professional Counselor
- Bourbonnais, IL
National Provider Identifier
1669027934
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Professional Counselor
- License
- 180008652
- Practice address
- 70 Ken Hayes Dr
Bourbonnais, IL 60914-9379 - Phone
- (815) 690-5587
- NPI assigned
- Aug 5, 2019
- 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 | 180008652 | IL | Primary |
Addresses
Primary practice location
70 Ken Hayes Dr
Bourbonnais, IL 60914-9379
Mailing address
4820 S State Route 45 52
Kankakee, IL 60901-6047
Phone (815) 690-5587
Other practice location 1
4820 S State Route 45 52
Kankakee, IL 60901-6047
Phone (815) 690-5587
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 |
|---|---|---|---|
| 180008652 | IL | MD | Professional Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1564963200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1564963200000",
"number": "1669027934",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4820 S STATE ROUTE 45 52",
"city": "KANKAKEE",
"state": "IL",
"postal_code": "609016047",
"telephone_number": "815-690-5587"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "70 KEN HAYES DR",
"city": "BOURBONNAIS",
"state": "IL",
"postal_code": "609149379",
"telephone_number": "815-690-5587"
}
],
"practiceLocations": [
{
"address_1": "4820 S State Route 45 52",
"address_purpose": "LOCATION",
"city": "Kankakee",
"state": "IL",
"postal_code": "609016047",
"country_code": "US",
"telephone_number": "815-690-5587",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "HAMILTON",
"first_name": "ELISHA",
"name_prefix": "Mrs.",
"credential": "LCPC",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2019-08-05",
"last_updated": "2019-08-05",
"status": "A"
},
"taxonomies": [
{
"code": "101YP2500X",
"taxonomy_group": "",
"desc": "Counselor, Professional",
"state": "IL",
"license": "180008652",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Bourbonnais, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 5, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.