Individual provider Active NPI

Yolanda Kaczmarczyk, LPC

  • Professional Counselor
  • St Charles, IL
National Provider Identifier
1689322745
Registry record updated Mar 16, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
178.017350 Issued in IL
Practice address
2570 Foxfield Rd Ste 107
St Charles, IL 60174-1406
Phone
(630) 884-8648
NPI assigned
Mar 16, 2022
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 16, 2022

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 178.017350 IL Primary

Addresses

Primary practice location

2570 Foxfield Rd Ste 107
St Charles, IL 60174-1406

Mailing address

1709 Cunningham LN
Crystal Lake, IL 60014-1903
Phone (779) 302-0184

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

LicenseStateTypeSpecialty
178.017350ILMDProfessional Counselor

NPI Registry JSON

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

{
    "created_epoch": "1647388800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1647388800000",
    "number": "1689322745",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1709 CUNNINGHAM LN",
            "city": "CRYSTAL LAKE",
            "state": "IL",
            "postal_code": "600141903",
            "telephone_number": "779-302-0184"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2570 FOXFIELD RD STE 107",
            "city": "ST CHARLES",
            "state": "IL",
            "postal_code": "601741406",
            "telephone_number": "630-884-8648"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KACZMARCZYK",
        "first_name": "YOLANDA",
        "name_prefix": "Mrs.",
        "credential": "LPC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-03-16",
        "last_updated": "2022-03-16",
        "certification_date": "2022-03-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "IL",
            "license": "178.017350",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in St Charles, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 16, 2022; 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.