Individual provider Active NPI

Michaela Hartzer, LCPC

  • Professional Counselor
  • Antioch, IL
National Provider Identifier
1992523112
Registry record updated Sep 26, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
180.003208 Issued in IL
Practice address
311 W Depot St Ste M
Antioch, IL 60002-1500
Phone
(331) 725-1190
NPI assigned
Sep 26, 2024
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 26, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Professional Counselor 101YP2500X 180.003208 IL Primary

Addresses

Primary practice location

311 W Depot St Ste M
Antioch, IL 60002-1500

Mailing address

410 Clearview LN
Lake Villa, IL 60046-5747

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
180.003208ILMDProfessional Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
New Leaf Counseling CurrentSince Jun 3, 2025 Accepting new patients

Locations

311 W Depot St
Ste M
Antioch, IL 60002
Phone (331) 725-1190

Organizations & group practices 1

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": "1727308800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1727308800000",
    "number": "1992523112",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "410 CLEARVIEW LN",
            "city": "LAKE VILLA",
            "state": "IL",
            "postal_code": "600465747"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "311 W DEPOT ST STE M",
            "city": "ANTIOCH",
            "state": "IL",
            "postal_code": "600021500",
            "telephone_number": "331-725-1190"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HARTZER",
        "first_name": "MICHAELA",
        "credential": "LCPC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-09-26",
        "last_updated": "2024-09-26",
        "certification_date": "2024-09-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "IL",
            "license": "180.003208",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Antioch, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 26, 2024; 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.