Active NPI
Phanisushma Cheturvedula, LPC
- Mental Health Counselor
- Elmhurst, IL
National Provider Identifier
1821683905
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Mental Health Counselor
- License
- 178016773
- Practice address
- 180 W Park Ave
Elmhurst, IL 60126-3357 - Phone
- (704) 657-2729
- NPI assigned
- Mar 1, 2021
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | 178016773 | IL | Primary |
Addresses
Primary practice location
180 W Park Ave
Elmhurst, IL 60126-3357
Mailing address
1000 Bayside Dr Unit 105
Palatine, IL 60074-3224
Phone (704) 657-2729
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)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 178016773 | IL | MD | Mental Health Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1614556800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1614556800000",
"number": "1821683905",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1000 BAYSIDE DR UNIT 105",
"city": "PALATINE",
"state": "IL",
"postal_code": "600743224",
"telephone_number": "704-657-2729"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "180 W PARK AVE",
"city": "ELMHURST",
"state": "IL",
"postal_code": "601263357",
"telephone_number": "704-657-2729"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CHETURVEDULA",
"first_name": "PHANISUSHMA",
"credential": "LPC",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2021-03-01",
"last_updated": "2021-03-01",
"certification_date": "2021-03-01",
"status": "A"
},
"taxonomies": [
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": "IL",
"license": "178016773",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Elmhurst, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 1, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.