Individual provider Active NPI

Mary Maraventano Stried

  • Counselor
  • Chicago, IL
National Provider Identifier
1821340613
Registry record updated Oct 23, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
CounselorTaxonomy code 101Y00000X
License
178009578 Issued in IL
Practice address
200 W Madison St Ste 2100
Chicago, IL 60606-3521
Phone
(224) 470-8061
Fax
(773) 353-1581
NPI assigned
Oct 4, 2012
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 23, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Counselor 101Y00000X 178009578 IL Primary

Addresses

Primary practice location

200 W Madison St Ste 2100
Chicago, IL 60606-3521

Mailing address

200 W Madison St Ste 2100
Chicago, IL 60606-3521
Phone (224) 470-8061

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
I20250109003466 IL Practitioner - Mental Health Counselor 6901334598 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
R Franklin University of Med & Sci/Chicago Medical School, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Healthy Life LLCGroup PAC ID 6608118435, 2 clinicians

Practice addresses (Care Compare)

205 N Michigan Ave
Suite 810
Chicago, IL 60601-5902
Phone (312) 736-2903

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
178009578ILMDCounselor

Practice roles

OrganizationSpecialtyStatusNew patients
Healthy Life, LLC CurrentSince Dec 1, 2024 Accepting new patients

Locations

205 N Michigan Ave
Ste 810
Chicago, IL 60601
Phone (312) 279-8628

200 W Madison St
Ste 2100
Chicago, IL 60606
Phone (312) 277-4090

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": "1349308800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1571788800000",
    "number": "1821340613",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "200 W MADISON ST STE 2100",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606063521",
            "telephone_number": "224-470-8061",
            "fax_number": "773-353-1581"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 W MADISON ST STE 2100",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606063521",
            "telephone_number": "224-470-8061",
            "fax_number": "773-353-1581"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARAVENTANO STRIED",
        "first_name": "MARY",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-10-04",
        "last_updated": "2019-10-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": "IL",
            "license": "178009578",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chicago, IL

Sources for this page

Verify at the official NPI Registry.