Individual provider Active NPI

Mary F Heraty, LCPC

  • Professional Counselor
  • Crystal Lake, IL
National Provider Identifier
1750464483
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
Practice address
101 N Virginia St
Suite 190
Crystal Lake, IL 60014
Phone
(815) 823-2299
Fax
(815) 301-9914
NPI assigned
Oct 24, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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 IL Primary

Addresses

Primary practice location

101 N Virginia St
Suite 190
Crystal Lake, IL 60014

Mailing address

101 N Virginia St
Suite 190
Crystal Lake, IL 60014
Phone (815) 823-2299

Other names 1

  • Mrs. Mary P Heraty Professional name

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
I20240509002927 IL Practitioner - Mental Health Counselor 6608062187 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
180001702ILMDProfessional Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Harmony Counseling Services LLC CurrentSince Mar 20, 2024 Accepting new patients

Locations

457 Coventry Ln
Ste 115
Crystal Lake, IL 60014
Phone (815) 245-4825

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": "1161648000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1750464483",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "101 N VIRGINIA ST",
            "address_2": "SUITE 190",
            "city": "CRYSTAL LAKE",
            "state": "IL",
            "postal_code": "60014",
            "telephone_number": "815-823-2299",
            "fax_number": "815-301-9914"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "101 N VIRGINIA ST",
            "address_2": "SUITE 190",
            "city": "CRYSTAL LAKE",
            "state": "IL",
            "postal_code": "60014",
            "telephone_number": "815-823-2299",
            "fax_number": "815-301-9914"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HERATY",
        "first_name": "MARY",
        "middle_name": "F",
        "name_prefix": "Mrs.",
        "credential": "LCPC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-10-24",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "IL",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MARY",
            "last_name": "HERATY",
            "middle_name": "P",
            "prefix": "MRS.",
            "credential": "LCPC",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

Other providers in Crystal Lake, IL

Sources for this page

Verify at the official NPI Registry.