Active NPI
Merrick O'Connell, LCSW
- Mental Health Counselor
- Lansing, IL
National Provider Identifier
1861719973
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Mental Health Counselor
- License
- 149.011664
- Practice address
- 1955 Bernice Rd Ste 1NW
Lansing, IL 60438-6049 - Phone
- (708) 474-7601
- Fax
- (708) 474-7615
- NPI assigned
- Apr 28, 2010
- 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 |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | 149.011664 | IL | Primary |
Addresses
Primary practice location
1955 Bernice Rd Ste 1NW
Lansing, IL 60438-6049
Mailing address
1955 Bernice Rd Ste 1NW
Lansing, IL 60438-6049
Phone (708) 474-7601
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 |
|---|---|---|---|
| 149.011664 | IL | MD | Mental Health Counselor |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| The Success Center | 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.
-
- Community/Behavioral Health Agency
- Lansing, IL
- NPI 1568795318
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1272412800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1272412800000",
"number": "1861719973",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1955 BERNICE RD STE 1NW",
"city": "LANSING",
"state": "IL",
"postal_code": "604386049",
"telephone_number": "708-474-7601",
"fax_number": "708-474-7615"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1955 BERNICE RD STE 1NW",
"city": "LANSING",
"state": "IL",
"postal_code": "604386049",
"telephone_number": "708-474-7601",
"fax_number": "708-474-7615"
}
],
"practiceLocations": [],
"basic": {
"last_name": "O'CONNELL",
"first_name": "MERRICK",
"credential": "LCSW",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2010-04-28",
"last_updated": "2010-04-28",
"status": "A"
},
"taxonomies": [
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": "IL",
"license": "149.011664",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Lansing, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 28, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.