Individual provider Active NPI

Mona M Manning

  • Professional Counselor
  • Fairfield, OH
National Provider Identifier
1992145742
Registry record updated Sep 2, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
E1800661 Issued in OH
Practice address
1760 Gloucester Dr
Fairfield, OH 45014-3710
Phone
(708) 951-4756
NPI assigned
Jun 26, 2013
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 2, 2026

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Professional Counselor 101YP2500X E1800661 OH Primary
Professional Counselor 101YP2500X 180008256 IL
Professional Counselor 101YP2500X 6401226294 MI

Addresses

Primary practice location

1760 Gloucester Dr
Fairfield, OH 45014-3710

Mailing address

1760 Gloucester Dr # 2
Fairfield, OH 45014-3710
Phone (708) 951-4756

Other practice location 1

1096 S Wildwood Ave
Kankakee, IL 60901-5374
Phone (708) 951-4756

Other practice location 2

4340 Aztec Way
Okemos, MI 48864-5242
Phone (708) 951-4756

Other names 1

  • Mona Mason Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240102001592 IL Practitioner - Mental Health Counselor 9032569173 Practice locations: Kankakee, IL

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
180008256ILMDProfessional Counselor
E1800661OHMDProfessional Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Mona M Mason LPCC LLC Professional PastSince Oct 1, 2023 Accepting new patients
Statistica Psychological Testing & Consulting Services Past Accepting new patients

Interoperability endpoints

  • Direct secure messaging: pbc.monamason@140097.advancedmd-direct.com

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": "1372204800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1788307200000",
    "number": "1992145742",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1760 GLOUCESTER DR # 2",
            "city": "FAIRFIELD",
            "state": "OH",
            "postal_code": "450143710",
            "telephone_number": "708-951-4756"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1760 GLOUCESTER DR",
            "city": "FAIRFIELD",
            "state": "OH",
            "postal_code": "450143710",
            "telephone_number": "708-951-4756"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1096 S Wildwood Ave",
            "address_purpose": "LOCATION",
            "city": "Kankakee",
            "state": "IL",
            "postal_code": "609015374",
            "country_code": "US",
            "telephone_number": "708-951-4756",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "4340 Aztec Way",
            "address_purpose": "LOCATION",
            "city": "Okemos",
            "state": "MI",
            "postal_code": "488645242",
            "country_code": "US",
            "telephone_number": "708-951-4756",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MANNING",
        "first_name": "MONA",
        "middle_name": "M",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2013-06-26",
        "last_updated": "2026-09-02",
        "certification_date": "2026-09-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "OH",
            "license": "E1800661",
            "primary": true
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "IL",
            "license": "180008256",
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "MI",
            "license": "6401226294",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MONA",
            "last_name": "MASON",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Fairfield, OH

Sources for this page

Verify at the official NPI Registry.