Margo D Bristow, MA, LPC, CADC, PCGC,

Primary specialty

CounselorTaxonomy code 101Y00000X

License

178.004883 Issued in IL

Practice address

6912 Main St Ste 26
Downers Grove, IL 60516-3447

Phone

(847) 791-1651

Fax

(855) 791-1651

NPI assigned

Apr 10, 2019

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Arts

State licenses

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

{
    "created_epoch": "1554854400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1554854400000",
    "number": "1669935276",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1142 CHICAGO AVE STE 2W",
            "city": "OAK PARK",
            "state": "IL",
            "postal_code": "603021837",
            "telephone_number": "847-791-1651",
            "fax_number": "855-791-1651"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6912 MAIN ST STE 26",
            "city": "DOWNERS GROVE",
            "state": "IL",
            "postal_code": "605163447",
            "telephone_number": "847-791-1651",
            "fax_number": "855-791-1651"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRISTOW",
        "first_name": "MARGO",
        "middle_name": "D",
        "credential": "MA, LPC, CADC, PCGC,",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-04-10",
        "last_updated": "2019-04-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": "IL",
            "license": "178.004883",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "mdb@margobristow.com",
            "affiliation": "N",
            "endpointDescription": "email cache for all billing to corporation",
            "use": "DIRECT",
            "useDescription": "Direct",
            "useOtherDescription": "information",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "email cache",
            "address_1": "1142 Chicago Ave Ste 2W",
            "city": "Oak Park",
            "state": "IL",
            "country_code": "US",
            "postal_code": "603021837",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

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• Counselor in Downers Grove, IL
• Providers in Downers Grove, IL by specialty
• Counselor in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 10, 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.

Verify at the official NPI Registry.