Sharon Holmes, LMFT
Individual provider Active NPI Mental Health Counselor · Richton Park, IL
NPI 1801463104 · NPPES record last updated Jun 25, 2025
Key facts
- NPI
- 1801463104
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Mental Health Counselor 101YM0800X
- License
- 166.001675 (IL)
- Practice address
- 22561 Pleasant Dr Apt 19
Richton Park, IL 60471-1727 - Phone
- (773) 969-6119
- NPI assigned
- Jun 7, 2021
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 4
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in IL
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: No · Power mobility devices: No · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20240215002345 | IL | Practitioner - Marriage and Family Therapist | 8123462322 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 166.001675 | IL | MD | Mental Health Counselor |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Imago Dei Mental Wellness, LLC | Mental Health | Current |
Accepting new patients |
| Endeavor Health Medical Group | Current |
Accepting new patients | |
| The Transformation Specialists LLC | Current |
Accepting new patients | |
| Endeavor Health Medical Group | Current |
Accepting new patients |
Locations
9532 Eagle Way
Chicago, IL 60678
155 E Brush Hill Rd
Elmhurst, IL 60126
Phone (331) 221-3521
2650 Ridge Ave
Evanston, IL 60201
Phone (847) 570-1206
2650 Ridge Ave
#1223
Evanston, IL 60201
Phone (847) 982-3172
2650 Ridge Ave
Ste 2218A
Evanston, IL 60201
Phone (847) 503-4222
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Counselor | 101Y00000X | 178016782 | IL | |
| Marriage & Family Therapist | 106H00000X | 178016782 | IL | |
| Mental Health Counselor | 101YM0800X | 166.001675 | IL | Yes |
Addresses
Primary practice location
22561 Pleasant Dr Apt 19
Richton Park, IL 60471-1727
Mailing address
22561 Pleasant Dr Apt 19
Richton Park, IL 60471-1727
Phone (773) 969-6119
Other practice location 1
31 W 155th St
Harvey, IL 60426-3556
Phone (708) 596-5177
Other practice location 2
813 Ash St
Flossmoor, IL 60422-2213
Phone (708) 381-1170
Other practice location 3
2650 Ridge Ave # 1223
Evanston, IL 60201-1700
Phone (475) 702-0408
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 178016782 | Medicaid | IL |
Other providers in Richton Park, IL
- Rosa Elestine Harris
- Eric V Harwell
- Chauntina L. Haskin
- Heavenly Helpers
- Here and There Transportation
- Lashonda Howell
- Icg Home Health
- Nwadiutor O Ifezue
- Imago Dei Mental Wellness, LLC
- Innerwork Wellness, LLC
All providers in Richton Park, IL · Mental Health Counselor in Illinois
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jun 25, 2025. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.