Janine Marie Phan, MA, LPC

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

178.015014 Issued in IL

Practice address

1010 Lake St Ste 500
Oak Park, IL 60301-1135

Phone

(773) 665-8052

NPI assigned

Jul 21, 2020

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

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

Specialty

Mental Health Counselor

Education

Other, 2018

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Smart Love Parenting CenterGroup PAC ID 8729261011, 11 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Master of Arts

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.

• Smart Love Parenting Center

  • Community/Behavioral Health Agency
  • Oak Park, IL
  • NPI 1922206101
  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1595289600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1595289600000",
    "number": "1801404348",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1020 W LAWRENCE AVE APT 531",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606405007",
            "telephone_number": "616-821-4241"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1010 LAKE ST STE 500",
            "city": "OAK PARK",
            "state": "IL",
            "postal_code": "603011135",
            "telephone_number": "773-665-8052"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PHAN",
        "first_name": "JANINE",
        "middle_name": "MARIE",
        "credential": "MA, LPC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-07-21",
        "last_updated": "2020-07-21",
        "certification_date": "2020-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "IL",
            "license": "178.015014",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Kimberly Kay Peyton Reyes, LCPC, MT-BC
• Sean Phelan, DPT
• Kimberly Phelps
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• Elaine Phillips, LPC
• Physiotherapy Associates

• Mental Health Counselor in Oak Park, IL
• Providers in Oak Park, 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 Jul 21, 2020; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.