Individual provider Active NPI

Melissa Marie Kozlowski, LCPC

  • Counselor
  • Geneva, IL
National Provider Identifier
1730503608
Registry record updated Dec 31, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
CounselorTaxonomy code 101Y00000X
License
180.008869 Issued in IL
Practice address
115 Campbell St Ste 203
Geneva, IL 60134-2777
Phone
(815) 531-4104
Fax
(815) 722-4390
NPI assigned
Feb 12, 2014
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 31, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Counselor 101Y00000X 180.008869 IL Primary

Addresses

Primary practice location

115 Campbell St Ste 203
Geneva, IL 60134-2777

Mailing address

339 Commerce Street
Aurora, IL 60504
Phone (815) 531-4104

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
180.008869ILMDCounselor

Practice roles

OrganizationSpecialtyStatusNew patients
Melissa Kozlowski, LLC Counselor CurrentSince Jan 5, 2020 Accepting new patients

Locations

115 Campbell St
Ste 208
Geneva, IL 60134
Phone (630) 339-4746

115 Campbell St
Ste 203
Geneva, IL 60134
Phone (815) 531-4104

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1392163200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1577750400000",
    "number": "1730503608",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "339 COMMERCE STREET",
            "city": "AURORA",
            "state": "IL",
            "postal_code": "60504",
            "telephone_number": "815-531-4104",
            "fax_number": "815-722-4390"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "115 CAMPBELL ST STE 203",
            "city": "GENEVA",
            "state": "IL",
            "postal_code": "601342777",
            "telephone_number": "815-531-4104",
            "fax_number": "815-722-4390"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KOZLOWSKI",
        "first_name": "MELISSA",
        "middle_name": "MARIE",
        "name_prefix": "Ms.",
        "credential": "LCPC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-02-12",
        "last_updated": "2019-12-31",
        "certification_date": "2019-12-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": "IL",
            "license": "180.008869",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Geneva, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 31, 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.