Active NPI
Martha Gates, LPC
- Professional Counselor
- Chicago, IL
National Provider Identifier
1851682207
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Professional Counselor
- License
- 178-003019
- Practice address
- 1525 East 53Rd Street
Suite #503
Chicago, IL 60615 - Phone
- (708) 837-4673
- NPI assigned
- Apr 20, 2011
- 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Professional Counselor | 101YP2500X | 178-003019 | IL | Primary |
Addresses
Primary practice location
1525 East 53Rd Street
Suite #503
Chicago, IL 60615
Mailing address
500 Park Avenue
Unit #631
Calumet City, IL 60409-5034
Phone (708) 837-4673
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 9325686 | Other | AETNA |
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)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 178-003019 | IL | MD | Professional Counselor |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Gates of Hope Professional Corporation | Professional | Past | Accepting new patients |
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.
-
- Professional Counselor
- Chicago, IL
- NPI 1669763017
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1303257600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1322611200000",
"number": "1851682207",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "500 PARK AVENUE",
"address_2": "UNIT #631",
"city": "CALUMET CITY",
"state": "IL",
"postal_code": "604095034",
"telephone_number": "708-837-4673"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1525 EAST 53RD STREET",
"address_2": "SUITE #503",
"city": "CHICAGO",
"state": "IL",
"postal_code": "60615",
"telephone_number": "708-837-4673"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GATES",
"first_name": "MARTHA",
"name_prefix": "Miss",
"credential": "LPC",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2011-04-20",
"last_updated": "2011-11-30",
"status": "A"
},
"taxonomies": [
{
"code": "101YP2500X",
"taxonomy_group": "",
"desc": "Counselor, Professional",
"state": "IL",
"license": "178-003019",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "AETNA",
"identifier": "9325686",
"state": null
}
],
"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 Nov 30, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.