Individual provider Active NPI

Andrew Obrien, LCPC

  • Professional Counselor
  • Wheaton, IL
National Provider Identifier
1740550342
Registry record updated Jan 12, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
180.006718 Issued in IL
Practice address
111 N County Farm Rd
Wheaton, IL 60187-3977
Phone
(630) 682-7400
Fax
(630) 590-5258
NPI assigned
Jan 12, 2012
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 12, 2012

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 180.006718 IL Primary

Addresses

Primary practice location

111 N County Farm Rd
Wheaton, IL 60187-3977

Mailing address

111 N County Farm Rd
Wheaton, IL 60187-3977
Phone (630) 682-7400

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
I20240123002175 IL Practitioner - Mental Health Counselor 1658723952 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 1999
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
County of Dupage Department of HealthGroup PAC ID 4981695103, 30 clinicians

Practice addresses (Care Compare)

111 N County Farm Rd
Wheaton, IL 60187-3977
Phone (630) 682-7400

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
180.006718ILMDProfessional Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
County of Dupage Department of Health Current Accepting new patients
County of Dupage Department of Health CurrentSince Jan 1, 2024 Accepting new patients
County of Dupage Department of Health CurrentSince Jan 1, 2024 Accepting new patients

Locations

111 N County Farm Rd
Wheaton, IL 60187
Phone (630) 627-1700

Organizations & group practices 3

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": "1326326400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1326326400000",
    "number": "1740550342",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "111 N COUNTY FARM RD",
            "city": "WHEATON",
            "state": "IL",
            "postal_code": "601873977",
            "telephone_number": "630-682-7400",
            "fax_number": "630-590-5258"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "111 N COUNTY FARM RD",
            "city": "WHEATON",
            "state": "IL",
            "postal_code": "601873977",
            "telephone_number": "630-682-7400",
            "fax_number": "630-590-5258"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OBRIEN",
        "first_name": "ANDREW",
        "credential": "LCPC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-01-12",
        "last_updated": "2012-01-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "IL",
            "license": "180.006718",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Wheaton, IL

Sources for this page

Verify at the official NPI Registry.