Nicholas Fedele, LCPC

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

178010043 Issued in IL

Practice address

27W130 Roosevelt Rd Ste 203
Winfield, IL 60190-1643

Phone

(630) 588-8490

Fax

(630) 588-8491

NPI assigned

Feb 26, 2015

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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.

• Pathways Psychology Services P.C.

  • Clinical Psychologist
  • Winfield, IL
  • NPI 1942485198
  NPD (past)

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

{
    "created_epoch": "1424908800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1427760000000",
    "number": "1912399064",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "27W130 ROOSEVELT RD STE 203",
            "city": "WINFIELD",
            "state": "IL",
            "postal_code": "601901643",
            "telephone_number": "630-588-8490",
            "fax_number": "630-588-8491"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "27W130 ROOSEVELT RD STE 203",
            "city": "WINFIELD",
            "state": "IL",
            "postal_code": "601901643",
            "telephone_number": "630-588-8490",
            "fax_number": "630-588-8491"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FEDELE",
        "first_name": "NICHOLAS",
        "credential": "LCPC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-02-26",
        "last_updated": "2015-03-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "IL",
            "license": "178010043",
            "primary": true
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "IL",
            "license": "180009484",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GROUP NPI",
            "identifier": "1144352626",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Kaleigh L Evans, M.D.
• Steven Philip Ewert, MD
• Expressive Healthcare Solutions, Inc.
• Faraaz Fakih, M.D.
• Saud M Farooqi, MD
• Dorothy Anne Fedor, PA-C
• Ann D Feehan, P.T.
• Susan M Felber, M.D.
• Amy E Fichtel, APRN, CNP
• Daniel M Fidanze, DDS

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 31, 2015; 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.