Nicole Penz, LCSW

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

149.020581 Issued in IL

Practice address

355 Ridge Ave FL 2
Evanston, IL 60202-3328

Phone

(847) 316-6262

NPI assigned

Oct 25, 2018

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

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1540425600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1540425600000",
    "number": "1780151910",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "355 RIDGE AVE FL 2",
            "city": "EVANSTON",
            "state": "IL",
            "postal_code": "602023328"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "355 RIDGE AVE FL 2",
            "city": "EVANSTON",
            "state": "IL",
            "postal_code": "602023328",
            "telephone_number": "847-316-6262"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PENZ",
        "first_name": "NICOLE",
        "name_prefix": "Miss",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-10-25",
        "last_updated": "2018-10-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "IL",
            "license": "149.020581",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Mehul Pema, DO
• Aimee Jane Aledia Pena, RPT
• Veronica Pena, LCPC
• Rebecca Peng, PHARM D
• Carliann Pentz
• Angela Perez-Martinez
• Marcella Victoria Perez, DO
• Ramoncito Perez, APN- CRNA
• Adem Perezic, RN
• Periodontics & Implants, LTD.

• Mental Health Counselor in Evanston, IL
• Providers in Evanston, IL by specialty
• Mental Health Counselor in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 25, 2018; 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.