Active NPI
Stacey Sherrie Seals, LCPC
- Professional Counselor
- Chicago, IL
National Provider Identifier
1831693829
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Professional Counselor
- License
- 180012959
- Practice address
- 612 S Western Ave
Chicago, IL 60612-4680 - Phone
- (330) 331-9955
- NPI assigned
- Mar 22, 2018
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Counselor | 101Y00000X | |||
| Addiction (Substance Use Disorder) Counselor | 101YA0400X | |||
| Professional Counselor | 101YP2500X | 180012959 | IL | Primary |
Addresses
Primary practice location
612 S Western Ave
Chicago, IL 60612-4680
Mailing address
15010 S Ravinia Ave Ste 15
Orland Park, IL 60462-5353
Phone (708) 364-0580
Other identifiers 3
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 30527 | Other | IL | CADC |
| 178012565 | Other | IL | LPC |
| 30847 | Other | IL | CODP I |
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
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1521676800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1592611200000",
"number": "1831693829",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "15010 S RAVINIA AVE STE 15",
"city": "ORLAND PARK",
"state": "IL",
"postal_code": "604625353",
"telephone_number": "708-364-0580"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "612 S WESTERN AVE",
"city": "CHICAGO",
"state": "IL",
"postal_code": "606124680",
"telephone_number": "330-331-9955"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SEALS",
"first_name": "STACEY",
"middle_name": "SHERRIE",
"credential": "LCPC",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2018-03-22",
"last_updated": "2020-06-20",
"certification_date": "2020-06-20",
"status": "A"
},
"taxonomies": [
{
"code": "101Y00000X",
"taxonomy_group": "",
"desc": "Counselor",
"state": null,
"license": null,
"primary": false
},
{
"code": "101YA0400X",
"taxonomy_group": "",
"desc": "Counselor, Addiction (Substance Use Disorder)",
"state": null,
"license": null,
"primary": false
},
{
"code": "101YP2500X",
"taxonomy_group": "",
"desc": "Counselor, Professional",
"state": "IL",
"license": "180012959",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "CADC",
"identifier": "30527",
"state": "IL"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "LPC",
"identifier": "178012565",
"state": "IL"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "CODP I",
"identifier": "30847",
"state": "IL"
}
],
"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 Jun 20, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.