Active NPI
Kenyata M Fletcher, PHD, LPC, CRADC
- Counselor
- Westchester, IL
National Provider Identifier
1669254751
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Counselor
- License
- 178.019144
- Practice address
- 1549 Balmoral Ave
Westchester, IL 60154-3638 - Phone
- (708) 299-9282
- NPI assigned
- Oct 16, 2023
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Addiction (Substance Use Disorder) Counselor | 101YA0400X | 25645 | IL | |
| Counselor | 101Y00000X | 178.019144 | IL | Primary |
Addresses
Primary practice location
1549 Balmoral Ave
Westchester, IL 60154-3638
Mailing address
1549 Balmoral Ave
Westchester, IL 60154-3638
Phone (708) 299-9282
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
- Credentials
- Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 178.019144 | IL | MD | Counselor |
| 25645 | IL | MD | Addiction (Substance Use Disorder) Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1697414400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1697414400000",
"number": "1669254751",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1549 BALMORAL AVE",
"city": "WESTCHESTER",
"state": "IL",
"postal_code": "601543638",
"telephone_number": "708-299-9282"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1549 BALMORAL AVE",
"city": "WESTCHESTER",
"state": "IL",
"postal_code": "601543638",
"telephone_number": "708-299-9282"
}
],
"practiceLocations": [],
"basic": {
"last_name": "FLETCHER",
"first_name": "KENYATA",
"middle_name": "M",
"name_prefix": "Ms.",
"credential": "PHD, LPC, CRADC",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2023-10-16",
"last_updated": "2023-10-16",
"certification_date": "2023-10-14",
"status": "A"
},
"taxonomies": [
{
"code": "101YA0400X",
"taxonomy_group": "",
"desc": "Counselor, Addiction (Substance Use Disorder)",
"state": "IL",
"license": "25645",
"primary": false
},
{
"code": "101Y00000X",
"taxonomy_group": "",
"desc": "Counselor",
"state": "IL",
"license": "178.019144",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Westchester, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 16, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.