Joanna Grace Mucha, LCPC

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

180.009081 Issued in IL

Practice address

4750 N Sheridan Rd
Chicago, IL 60640-7528

Phone

(773) 751-4048

Fax

(773) 751-4174

NPI assigned

Dec 16, 2014

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• Joanna Grace Holt Former name

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

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.

• Advocate North Side Health Network

  • General Acute Care Hospital
  • Chicago, IL
  • NPI 1912014564
  Medicare reassignment NPD
• Advocate North Side Health Network

  • Institutional Pharmacy
  • Chicago, IL
  • NPI 1114645470
  NPD

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

{
    "created_epoch": "1418688000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1418688000000",
    "number": "1780082248",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4750 N SHERIDAN RD",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606407528",
            "telephone_number": "773-751-4048",
            "fax_number": "773-751-4174"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4750 N SHERIDAN RD",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606407528",
            "telephone_number": "773-751-4048",
            "fax_number": "773-751-4174"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MUCHA",
        "first_name": "JOANNA",
        "middle_name": "GRACE",
        "credential": "LCPC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-12-16",
        "last_updated": "2014-12-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "IL",
            "license": "180.009081",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JOANNA",
            "last_name": "HOLT",
            "middle_name": "GRACE",
            "credential": "MA",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Samer Nabil Muallem, M.D.
• Ghassan M Mubarak
• Uzmah Mubashir
• Mohammed A Mubeen, M.D.,
• Michelle Mucasey
• Zak Mucha, LCSW
• Anna Muchler
• Bella Nathaly Mucino, LSW
• Claire Muckian
• Beth Muckler, DPT

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 16, 2014; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.