Heather Samardzija, M.A., LCPC

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

180.010026 Issued in IL

Practice address

24012 W Renwick Rd Ste 204a
Plainfield, IL 60544-8733

Phone

(815) 676-4688

NPI assigned

Sep 3, 2010

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Opted out of Medicare

Yes, effective May 7, 2024 through May 7, 2028

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.

• Sun and Moon Wellness PLLC

  • Adult Mental Health Clinic/Center
  • Aurora, IL
  • NPI 1952119075
  NPD Authorized official

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

{
    "created_epoch": "1283472000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1522713600000",
    "number": "1851608392",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2477 WILD DUNES CIR",
            "city": "AURORA",
            "state": "IL",
            "postal_code": "605035639",
            "telephone_number": "815-600-4678"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "24012 W RENWICK RD STE 204A",
            "city": "PLAINFIELD",
            "state": "IL",
            "postal_code": "605448733",
            "telephone_number": "815-676-4688"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SAMARDZIJA",
        "first_name": "HEATHER",
        "credential": "M.A., LCPC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2010-09-03",
        "last_updated": "2018-04-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "IL",
            "license": "178.007485",
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "IL",
            "license": "180.010026",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Rana Salameh, OD
• Rebekah Salazar
• Isabel Salgado
• Faaria Salik
• Mohin Tissa Samaraweera, MD
• Savitharani Sampath, M.D.,
• Sanctuary Psychiatric Services LLC
• Sanjay Pethkar, M.D., S. C.
• Mansi Sant, LCPC, CEDS
• Jeffrey Zamora Santos, PT

• Professional Counselor in Plainfield, IL
• Providers in Plainfield, IL by specialty
• Professional Counselor in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 3, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.