Active NPI
Kathleen Daly, LCPC
- Mental Health Counselor
- Chicago, IL
National Provider Identifier
1982449617
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Mental Health Counselor
- License
- 180.009852
- Practice address
- 3301 W 111TH St
Chicago, IL 60655-2715 - Phone
- (312) 469-0486
- NPI assigned
- Jun 25, 2024
- 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | 180.009852 | IL | Primary |
Addresses
Primary practice location
3301 W 111TH St
Chicago, IL 60655-2715
Mailing address
10647 S Central Park Ave
Chicago, IL 60655-3203
Phone (708) 408-0531
Other practice location 1
265 Stebbings Ct Ste 1
Bradley, IL 60915-1282
Phone (815) 200-8653
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Opted out of Medicare
- Yes, effective Jul 22, 2024 through Jul 22, 2028
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 180.009852 | IL | MD | Mental Health Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1719273600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1719273600000",
"number": "1982449617",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "10647 S CENTRAL PARK AVE",
"city": "CHICAGO",
"state": "IL",
"postal_code": "606553203",
"telephone_number": "708-408-0531"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3301 W 111TH ST",
"city": "CHICAGO",
"state": "IL",
"postal_code": "606552715",
"telephone_number": "312-469-0486"
}
],
"practiceLocations": [
{
"address_1": "265 Stebbings Ct Ste 1",
"address_purpose": "LOCATION",
"city": "Bradley",
"state": "IL",
"postal_code": "609151282",
"country_code": "US",
"telephone_number": "815-200-8653",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "DALY",
"first_name": "KATHLEEN",
"credential": "LCPC",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2024-06-25",
"last_updated": "2024-06-25",
"certification_date": "2024-06-25",
"status": "A"
},
"taxonomies": [
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": "IL",
"license": "180.009852",
"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 Jun 25, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Opt Out Affidavits.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.