MEDICARE: NATALIA NIEVES M. A.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	101YP2500X	Professional Counselor	180008545	IL
2	101YM0800X	Mental Health Counselor

General Provider Information

NPI Number	:	1265723886
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	NATALIA NIEVES M. A.

Provider Business Mailing Address
First Line	:	825 E GOLF RD STE 1127
Second Line	:
City	:	ARLINGTON HEIGHTS
State	:	IL
Zip	:	60005-5200
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	825 E GOLF RD STE 1127
Second Line	:
City	:	ARLINGTON HEIGHTS
State	:	IL
Zip	:	60005-5200
Country	:	US
Telephone Number	:	847-981-9200
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/29/2011
Last Update Date	:	03/27/2018

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Directions to “ NATALIA NIEVES M. A.” Practice Location

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