Individual provider Active NPI

Marina Vasiljevic, LCPC

  • Counselor
  • Downers Grove, IL
National Provider Identifier
1710498258
Registry record updated Dec 22, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
CounselorTaxonomy code 101Y00000X
License
178.013364 Issued in IL
Practice address
6912 Main St Ste 123
Downers Grove, IL 60516-3440
Phone
(630) 707-7217
Fax
(630) 964-3436
NPI assigned
Oct 23, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 22, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Counselor 101Y00000X 178.013364 IL Primary

Addresses

Primary practice location

6912 Main St Ste 123
Downers Grove, IL 60516-3440

Mailing address

6912 Main St Ste 123
Downers Grove, IL 60516-3440
Phone (630) 707-7217

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL
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
I20260105001708 IL Practitioner - Mental Health Counselor 6507352051 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Rockford Psychiatric Medical Services SCGroup PAC ID 6901089515, 154 clinicians

Practice addresses (Care Compare)

6319 Fairview Ave
Suite 102
Westmont, IL 60559-2889
Phone (630) 566-2096

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
178.013364ILMDCounselor

Practice roles

OrganizationSpecialtyStatusNew patients
Rockford Psychiatric Medical Services, S.C. CurrentSince Dec 23, 2025 Accepting new patients

Locations

1639 N Alpine Rd
Ste 260
Rockford, IL 61107
Phone (815) 395-1500

6319 Fairview Ave
Ste 102
Westmont, IL 60559
Phone (630) 566-2096

Interoperability endpoints

  • Direct secure messaging: marina.kostic.1@25899.direct.athenahealth.com

Organizations & group practices 1

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

NPI Registry JSON

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

{
    "created_epoch": "1508716800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1766361600000",
    "number": "1710498258",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6912 MAIN ST STE 123",
            "city": "DOWNERS GROVE",
            "state": "IL",
            "postal_code": "605163440",
            "telephone_number": "630-707-7217",
            "fax_number": "630-964-3436"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6912 MAIN ST STE 123",
            "city": "DOWNERS GROVE",
            "state": "IL",
            "postal_code": "605163440",
            "telephone_number": "630-707-7217",
            "fax_number": "630-964-3436"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VASILJEVIC",
        "first_name": "MARINA",
        "credential": "LCPC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-10-23",
        "last_updated": "2025-12-22",
        "certification_date": "2025-12-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": "IL",
            "license": "178.013364",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Downers Grove, IL

Sources for this page

Verify at the official NPI Registry.