Kathryn Carly Jackson-Griffin, MA, NCC

Primary specialty

CounselorTaxonomy code 101Y00000X

License

J25050387686 Issued in IL

Practice address

155 N Michigan Ave Ste 608
Chicago, IL 60601-7511

Phone

(312) 883-7060

Fax

(312) 883-7175

NPI assigned

Jan 25, 2011

Sex

Female

Sole proprietor

Yes

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not 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.

• Restorative Counseling, P.C.

  • Mental Health Counselor
  • Chicago, IL
  • NPI 1851837462
  NPD

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

{
    "created_epoch": "1295913600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1657584000000",
    "number": "1831494699",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "155 N MICHIGAN AVE STE 608",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606017511",
            "telephone_number": "312-883-7060",
            "fax_number": "312-883-7175"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "155 N MICHIGAN AVE STE 608",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606017511",
            "telephone_number": "312-883-7060",
            "fax_number": "312-883-7175"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1125 Tri State Pkwy",
            "address_2": "Suite 720",
            "address_purpose": "LOCATION",
            "city": "Gurnee",
            "state": "IL",
            "postal_code": "600319177",
            "country_code": "US",
            "telephone_number": "847-245-6587",
            "fax_number": "847-855-1609",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "JACKSON-GRIFFIN",
        "first_name": "KATHRYN",
        "middle_name": "CARLY",
        "name_prefix": "Ms.",
        "credential": "MA, NCC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2011-01-25",
        "last_updated": "2022-07-12",
        "certification_date": "2022-07-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": "IL",
            "license": "J25050387686",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jackson Park Hospital Foundation
• Jackson Park SLF, LLC
• Jackson Park Suppotive Living
• Jackson Square Skilled Nursing Aand Living
• Anais Karel Jackson-Gonzalez
• Jennifer L Jackson-Laurent, M.A. CCC-SLP
• Jameera Jahaan Jackson-Reyes, LPC
• Lakecia Jackson-Rooks, OTRL, D.T.
• Abbigail Jackson
• Adam Jackson, BMSCD, MBSC, CNIM

• Counselor in Chicago, IL
• Providers in Chicago, IL by specialty
• Counselor in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 12, 2022; 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.