Active NPI
Laura Bentley
- Professional Counselor
- Oak Park, IL
National Provider Identifier
1962068957
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Professional Counselor
- License
- 180.012263
- Practice address
- 610 S Maple Ave Ste 5601
Oak Park, IL 60304-1091 - Phone
- (773) 665-8052
- NPI assigned
- May 15, 2019
- 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 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Professional Counselor | 101YP2500X | 178011578 | IL | |
| Professional Counselor | 101YP2500X | 180.012263 | IL | Primary |
Addresses
Primary practice location
610 S Maple Ave Ste 5601
Oak Park, IL 60304-1091
Mailing address
6531 W Dickens Ave
2E
Chicago, IL 60707
Phone (630) 251-6172
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: No
- Medical equipment: Yes
- Home health: No
- Power mobility devices: No
- Hospice: No
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 178011578 | IL | MD | Professional Counselor |
| 180.012263 | IL | MD | Professional Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1557878400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1558310400000",
"number": "1962068957",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "6531 W DICKENS AVE",
"address_2": "2E",
"city": "CHICAGO",
"state": "IL",
"postal_code": "60707",
"telephone_number": "630-251-6172"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "610 S MAPLE AVE STE 5601",
"city": "OAK PARK",
"state": "IL",
"postal_code": "603041091",
"telephone_number": "773-665-8052"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BENTLEY",
"first_name": "LAURA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2019-05-15",
"last_updated": "2019-05-20",
"status": "A"
},
"taxonomies": [
{
"code": "101YP2500X",
"taxonomy_group": "",
"desc": "Counselor, Professional",
"state": "IL",
"license": "178011578",
"primary": false
},
{
"code": "101YP2500X",
"taxonomy_group": "",
"desc": "Counselor, Professional",
"state": "IL",
"license": "180.012263",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Oak Park, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 20, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.