Nicole Arlyn Fernandez, LMFT

Primary specialty

Marriage & Family TherapistTaxonomy code 106H00000X

License

166.001120 Issued in IL

Practice address

5126 W Agatite Ave
# 1
Chicago, IL 60630-3702

Phone

(773) 936-5844

NPI assigned

Feb 13, 2017

Last updated

Feb 13, 2017By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• Nicole Arlyn Duarte Professional name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Synergy Relational Therapy

  • Marriage & Family Therapist
  • Chicago, IL
  • NPI 1093515991
  NPD Authorized official

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

{
    "created_epoch": "1486944000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1486944000000",
    "number": "1881133601",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5126 W AGATITE AVE",
            "address_2": "# 1",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606303702",
            "telephone_number": "773-936-5844"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5126 W AGATITE AVE",
            "address_2": "# 1",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606303702",
            "telephone_number": "773-936-5844"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FERNANDEZ",
        "first_name": "NICOLE",
        "middle_name": "ARLYN",
        "name_prefix": "Mrs.",
        "credential": "LMFT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-02-13",
        "last_updated": "2017-02-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "IL",
            "license": "166.001120",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "NICOLE",
            "last_name": "DUARTE",
            "middle_name": "ARLYN",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

• Krystal Jacqueline Fernandez
• Lizabeth Fernandez
• Louis Fernandez, M.D.
• Manuel Felipe Fernandez, M.D.
• Milagros Fernandez, LCSW
• Rebecca Fernandez, LCPC
• Rosaura Fernandez, M.D.
• Rose Fernandez, CSADC - MISA 11
• Severiano Fernandez, PTA
• Sonia Ivelis Fernandez, NURSE PRACTITIONER

• Marriage & Family Therapist in Chicago, IL
• Providers in Chicago, IL by specialty
• Marriage & Family Therapist in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 13, 2017; 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.