Individual provider Active NPI

Stephanie Estell Wollert, MA, LPC

  • Professional Counselor
  • Naperville, IL
National Provider Identifier
1679137582
Registry record updated Aug 16, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
178014820 Issued in IL
Practice address
2272 95TH St Ste 305
Naperville, IL 60564-8944
Phone
(630) 753-9800
NPI assigned
Apr 25, 2019
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 16, 2024

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 178014820 IL Primary

Addresses

Primary practice location

2272 95TH St Ste 305
Naperville, IL 60564-8944

Mailing address

3221 Grafton LN
Aurora, IL 60502-7009
Phone (815) 721-7151

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
Master of Arts

State licenses

LicenseStateTypeSpecialty
178014820ILMDProfessional Counselor

NPI Registry JSON

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

{
    "created_epoch": "1556150400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1723766400000",
    "number": "1679137582",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3221 GRAFTON LN",
            "city": "AURORA",
            "state": "IL",
            "postal_code": "605027009",
            "telephone_number": "815-721-7151"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2272 95TH ST STE 305",
            "city": "NAPERVILLE",
            "state": "IL",
            "postal_code": "605648944",
            "telephone_number": "630-753-9800"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WOLLERT",
        "first_name": "STEPHANIE",
        "middle_name": "ESTELL",
        "credential": "MA, LPC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-04-25",
        "last_updated": "2024-08-16",
        "certification_date": "2024-08-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "IL",
            "license": "178014820",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Naperville, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 16, 2024; 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.