Individual provider Active NPI

Shari Kalik-Miller, MS, NCC, LPC, JD

  • Counselor
  • Northbrook, IL
National Provider Identifier
1790329845
Registry record updated Nov 1, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
CounselorTaxonomy code 101Y00000X
Practice address
333 Skokie Blvd Ste 112
Northbrook, IL 60062-1624
Phone
(847) 796-1060
Fax
(847) 242-9641
NPI assigned
Nov 1, 2019
Last updated
Nov 1, 2019By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 1, 2019

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Counselor 101Y00000X Primary
Mental Health Counselor 101YM0800X

Addresses

Primary practice location

333 Skokie Blvd Ste 112
Northbrook, IL 60062-1624

Mailing address

333 Skokie Blvd Ste 112
Northbrook, IL 60062-1624
Phone (847) 796-1060

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
I20240228003179 IL Practitioner - Mental Health Counselor 7618397563 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
MyndflGroup PAC ID 5991240517, 3 clinicians

Practice addresses (Care Compare)

333 Skokie Blvd
Suite 101
Northbrook, IL 60062-1621
Phone (708) 232-6580

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Juris Doctor, Master of Science

Practice roles

OrganizationSpecialtyStatusNew patients
Myndfl Current Accepting new patients
Myndfl Mental Health CurrentSince May 10, 2024 Accepting new patients

Locations

333 Skokie Blvd
Ste 101
Northbrook, IL 60062
Phone (708) 232-6580

333 Skokie Blvd
Ste 108
Northbrook, IL 60062
Phone (847) 450-0404

333 Skokie Blvd
Ste 112
Northbrook, IL 60062
Phone (224) 205-7866

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": "1572566400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1572566400000",
    "number": "1790329845",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "333 SKOKIE BLVD STE 112",
            "city": "NORTHBROOK",
            "state": "IL",
            "postal_code": "600621624",
            "telephone_number": "847-796-1060"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "333 SKOKIE BLVD STE 112",
            "city": "NORTHBROOK",
            "state": "IL",
            "postal_code": "600621624",
            "telephone_number": "847-796-1060",
            "fax_number": "847-242-9641"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KALIK-MILLER",
        "first_name": "SHARI",
        "credential": "MS, NCC, LPC, JD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-11-01",
        "last_updated": "2019-11-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Northbrook, IL

Sources for this page

Verify at the official NPI Registry.