Individual provider Active NPI

Theodore Crittendon Allen, LPC

  • Professional Counselor
  • Chicago, IL
National Provider Identifier
1669041265
Registry record updated Oct 3, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
LPC015401 Issued in GA
Practice address
680 N Lake Shore Dr Ste 110-1113
Chicago, IL 60611-4546
Phone
(872) 205-0456
NPI assigned
Jun 18, 2021
Last updated
Oct 3, 2026By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 3, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Professional Counselor 101YP2500X LPC015401 GA Primary

Addresses

Primary practice location

680 N Lake Shore Dr Ste 110-1113
Chicago, IL 60611-4546

Mailing address

345 W Memorial Dr
Hinesville, GA 31313-2413
Phone (404) 409-0413

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20250212002468 GA Practitioner - Mental Health Counselor 9133659667 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Centerstone of Tennessee, Inc. CurrentSince Jan 10, 2025 Accepting new patients
Centerstone of Tennessee, Inc. CurrentSince Jan 10, 2025 Accepting new patients
All in Counseling and Consulting LLC Professional PastSince Jun 1, 2021 Accepting new patients

Locations

345 W Memorial Dr
Hinesville, GA 31313
Phone (912) 456-2010

1921 Ransom Pl
Nashville, TN 37217
Phone (615) 279-6700

Organizations & group practices 3

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

NPI Registry JSON

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

{
    "created_epoch": "1623974400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1790985600000",
    "number": "1669041265",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "345 W MEMORIAL DR",
            "city": "HINESVILLE",
            "state": "GA",
            "postal_code": "313132413",
            "telephone_number": "404-409-0413"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "680 N LAKE SHORE DR STE 110-1113",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606114546",
            "telephone_number": "872-205-0456"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ALLEN",
        "first_name": "THEODORE",
        "middle_name": "CRITTENDON",
        "name_prefix": "Mr.",
        "credential": "LPC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-06-18",
        "last_updated": "2026-10-03",
        "certification_date": "2026-10-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "GA",
            "license": "LPC015401",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chicago, IL

Sources for this page

Verify at the official NPI Registry.