Individual provider Active NPI

Rebekah Todd

  • Mental Health Counselor
  • Chicago, IL
National Provider Identifier
1801577705
Registry record updated May 31, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
Practice address
1147 W Ohio St Ste 103
Chicago, IL 60642-5874
Phone
(312) 772-9796
NPI assigned
Jul 25, 2023
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 31, 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 Primary
Professional Counselor 101YP2500X 178.020263 IL

Addresses

Primary practice location

1147 W Ohio St Ste 103
Chicago, IL 60642-5874

Mailing address

2625 W Belmont Ave Unit 3
Chicago, IL 60618-5966
Phone (314) 856-3714

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
178.020263ILMDProfessional Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Optimum Joy, P.C. Professional CurrentSince Jul 31, 2023 Accepting new patients

Locations

1147 W Ohio St
Ste 103
Chicago, IL 60642
Phone (312) 772-9796

19630 Governors Hwy
Ste 5
Flossmoor, IL 60422
Phone (708) 481-4257

112 Boeykens Pl
Ste 4D
Normal, IL 61761

Organizations & group practices 1

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": "1690243200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1717113600000",
    "number": "1801577705",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2625 W BELMONT AVE UNIT 3",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606185966",
            "telephone_number": "314-856-3714"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1147 W OHIO ST STE 103",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606425874",
            "telephone_number": "312-772-9796"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TODD",
        "first_name": "REBEKAH",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-07-25",
        "last_updated": "2024-05-31",
        "certification_date": "2024-05-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "IL",
            "license": "178.020263",
            "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 May 31, 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.