Logan Spicer

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

180015338 Issued in IL

Practice address

9855 W Roosevelt Rd
Westchester, IL 60154-2758

Phone

(708) 681-2325

NPI assigned

May 23, 2019

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

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

Specialty

Mental Health Counselor

Education

Other, 2020

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Thriveworks Clinical - IllinoisGroup PAC ID 6800263823, 45 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Thriveworks Clinical - Illinois

  • Mental Health Counselor
  • Chicago, IL
  • NPI 1164190633
  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1558569600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1692662400000",
    "number": "1770140949",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3123 S SHIELDS AVE APT BSMT",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606164967",
            "telephone_number": "317-619-9225"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9855 W ROOSEVELT RD",
            "city": "WESTCHESTER",
            "state": "IL",
            "postal_code": "601542758",
            "telephone_number": "708-681-2325"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SPICER",
        "first_name": "LOGAN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-05-23",
        "last_updated": "2023-08-22",
        "certification_date": "2023-08-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": "NONE",
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "IL",
            "license": "180015338",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Claretha Smith
• Robert David Smola, MSW, LCSW
• Edward J Snyder III
• Solace Counseling and Wellness PLLC
• Kenneth Latokunbo Soyemi, MD
• Eric Spratford, MD
• SSC Westchester Operating Company LLC
• Stanek and Associates Counceling Service
• Kenneth John Stanek, PHD
• Gregory Stanton, M.A.

• Professional Counselor in Westchester, IL
• Providers in Westchester, IL by specialty
• Professional Counselor in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.