Individual provider Active NPI

Jennifer Koriath, LCPC

  • Professional Counselor
  • Buffalo Grove, IL
National Provider Identifier
1982093373
Registry record updated Nov 16, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
180010701 Issued in IL
Practice address
1217 McHenry Rd Ste 233a
Buffalo Grove, IL 60089-1379
Phone
(847) 845-9149
NPI assigned
Jan 22, 2015
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 16, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Professional Counselor 101YP2500X
Professional Counselor 101YP2500X 180010701 IL Primary

Addresses

Primary practice location

1217 McHenry Rd Ste 233a
Buffalo Grove, IL 60089-1379

Mailing address

1217 McHenry Rd Ste 233a
Buffalo Grove, IL 60089-1379
Phone (224) 434-9176

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
180010701ILMDProfessional Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Teladoc Health Medical Group, P.a. Professional Current Accepting new patients
Thrive Counseling & Wellness PC Professional CurrentSince Aug 1, 2020 Accepting new patients

Locations

220 S Wilcox St
#1532
Castle Rock, CO 80104
Phone (224) 434-9176

1207 Old McHenry Rd
Ste 212
Buffalo Grove, IL 60089
Phone (847) 478-8332

1217 McHenry Rd
Ste 233A
Buffalo Grove, IL 60089
Phone (224) 434-9176

255 N Buffalo Grove Rd
Unit 7844
Buffalo Grove, IL 60089
Phone (224) 434-9176

Interoperability endpoints

  • Direct secure messaging: jenniferlang@tdh.allscriptsdirect.net

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": "1421884800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1668556800000",
    "number": "1982093373",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1217 MCHENRY RD STE 233A",
            "city": "BUFFALO GROVE",
            "state": "IL",
            "postal_code": "600891379",
            "telephone_number": "224-434-9176"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1217 MCHENRY RD STE 233A",
            "city": "BUFFALO GROVE",
            "state": "IL",
            "postal_code": "600891379",
            "telephone_number": "847-845-9149"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KORIATH",
        "first_name": "JENNIFER",
        "credential": "LCPC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2015-01-22",
        "last_updated": "2022-11-16",
        "certification_date": "2022-11-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "IL",
            "license": "180010701",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Buffalo Grove, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 16, 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.