Individual provider Active NPI

Caroline Srbeny

  • Mental Health Counselor
  • Chicago, IL
National Provider Identifier
1942918099
Registry record updated Nov 8, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
178018494 Issued in IL
Practice address
1209 W Diversey Pkwy Unit G-2
Chicago, IL 60614-1201
Phone
(773) 236-8566
NPI assigned
Nov 8, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 8, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X 178018494 IL Primary

Addresses

Primary practice location

1209 W Diversey Pkwy Unit G-2
Chicago, IL 60614-1201

Mailing address

1209 W Diversey Pkwy Unit G-2
Chicago, IL 60614-1201
Phone (773) 236-8566

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

LicenseStateTypeSpecialty
178018494ILMDMental Health Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Lilac Psychotherapy, PLLC Mental Health Current Accepting new patients
Renew You Counseling Center LLC CurrentSince Nov 13, 2022 Accepting new patients

Locations

1209 W Diversey Pkwy
Unit G2
Chicago, IL 60614
Phone (773) 236-8566

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1667865600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1667865600000",
    "number": "1942918099",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1209 W DIVERSEY PKWY UNIT G-2",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606141201",
            "telephone_number": "773-236-8566"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1209 W DIVERSEY PKWY UNIT G-2",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606141201",
            "telephone_number": "773-236-8566"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SRBENY",
        "first_name": "CAROLINE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-11-08",
        "last_updated": "2022-11-08",
        "certification_date": "2022-11-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "IL",
            "license": "178018494",
            "primary": true
        }
    ],
    "identifiers": [],
    "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 8, 2022; 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.