Nicole Marie Pena
Counselor, Mental Health in Chicago, IL. Individual provider (NPI-1).
NPI number1043789779
StatusActive
Last updated in NPPESNov 26, 2018
Details
- NPI
- 1043789779
- Entity type
- Individual (NPI-1)
- Name
- Nicole Marie Pena
- Sex
- Female
- Sole proprietor
- Yes
- Enumeration date
- Nov 26, 2018
- Last updated
- Nov 26, 2018
Medicare and OIG
- Medicare enrolled (PECOS)
- Not in the Medicare enrollment file
- Can order and refer
- Not on the CMS order and referring list
- OIG exclusion list
- This NPI is not listed
CMS and OIG files of November 2026. PECOS lookup · OIG exclusion check
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 101YM0800X | Counselor, Mental Health | – | – | Yes |
Practice location
2111 W. Congress PkwyChicago, IL 60612
Phone 224-201-7566
Mailing address
8630 Ferris Ave Unit 102Morton Grove, IL 60053-2833
Phone 224-201-7566
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This page shows exactly what the provider filed with NPPES. Only the provider (or their surrogate) can change it, by signing in to NPPES. Our page updates within a day of their change. See how to update NPI information.
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