Individual provider Active NPI

Carolyn Nevarez

  • Marriage & Family Therapist
  • Chicago, IL
National Provider Identifier
1801323894
Registry record updated Jan 3, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
License
166.001379 Issued in IL
Practice address
3111 W Monroe St
Chicago, IL 60612-3837
Phone
(312) 248-4091
Fax
(833) 681-0794
NPI assigned
May 22, 2017
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 3, 2024

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Counselor 101Y00000X 166.001379 IL
Marriage & Family Therapist 106H00000X 166.001379 IL Primary
Mental Health CounselorGroup: 193200000X MULTI-SPECIALTY GROUP 101YM0800X 166.001379 IL

Addresses

Primary practice location

3111 W Monroe St
Chicago, IL 60612-3837

Mailing address

3111 W Monroe St
Chicago, IL 60612-3837
Phone (419) 680-0989

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
166.001379ILMDMental Health Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Cedar Tree Counseling, LTD Marriage & Family Therapist Current Accepting new patients
Springtree Counseling, P.C. Counselor PastSince Apr 1, 2021 Accepting new patients
In Pursuit Counseling PLLC Mental Health PastSince Jan 7, 2024 Accepting new patients

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1495411200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1704240000000",
    "number": "1801323894",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3111 W MONROE ST",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606123837",
            "telephone_number": "419-680-0989"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3111 W MONROE ST",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606123837",
            "telephone_number": "312-248-4091",
            "fax_number": "833-681-0794"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NEVAREZ",
        "first_name": "CAROLYN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-05-22",
        "last_updated": "2024-01-03",
        "certification_date": "2024-01-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": "IL",
            "license": "166.001379",
            "primary": false
        },
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "IL",
            "license": "166.001379",
            "primary": true
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Mental Health",
            "state": "IL",
            "license": "166.001379",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chicago, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 3, 2024; 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.