Individual provider Active NPI

Amy Hong

  • Mental Health Counselor
  • Northbrook, IL
National Provider Identifier
1780309989
Registry record updated Sep 11, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
Practice address
1135 Skokie Blvd
Northbrook, IL 60062-4118
Phone
(224) 505-5665
NPI assigned
Oct 10, 2022
Last updated
Sep 11, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 11, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X NU Primary
Student in an Organized Health Care Education/Training Program 390200000X NU

Addresses

Primary practice location

1135 Skokie Blvd
Northbrook, IL 60062-4118

Mailing address

1135 Skokie Blvd
Northbrook, IL 60062-4118

Other practice location 1

1850 Oak St
Northfield, IL 60093-3042
Phone (224) 505-5665 ext. 722

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
I20241010001072 IL Practitioner - Mental Health Counselor 0840722278 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
The Josselyn Center NFPGroup PAC ID 0840289740, 86 clinicians

Practice addresses (Care Compare)

1135 Skokie Blvd
Northbrook, IL 60062-4118
Phone (847) 441-5600

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
The Josselyn Center NFP CurrentSince Sep 30, 2024 Accepting new patients
The Josselyn Center NFP CurrentSince Sep 30, 2024 Accepting new patients

Locations

1135 Skokie Blvd
Northbrook, IL 60062
Phone (224) 505-5665

1850 Oak St
Northfield, IL 60093
Phone (224) 505-5656

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1665360000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1726012800000",
    "number": "1780309989",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1135 SKOKIE BLVD",
            "city": "NORTHBROOK",
            "state": "IL",
            "postal_code": "600624118"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1135 SKOKIE BLVD",
            "city": "NORTHBROOK",
            "state": "IL",
            "postal_code": "600624118",
            "telephone_number": "224-505-5665"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1850 Oak St",
            "address_purpose": "LOCATION",
            "city": "Northfield",
            "state": "IL",
            "postal_code": "600933042",
            "country_code": "US",
            "telephone_number": "224-505-5665 x722",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HONG",
        "first_name": "AMY",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-10-10",
        "last_updated": "2024-09-11",
        "certification_date": "2024-09-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Northbrook, IL

Sources for this page

Verify at the official NPI Registry.