MEDICARE: JOSEPH FATTORI MCAP, RMHCI

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	101YM0800X	Mental Health Counselor
2	101YA0400X	Addiction (Substance Use Disorder) Counselor
3	101YP2500X	Professional Counselor	180.017058	IL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1962095836
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JOSEPH FATTORI MCAP, RMHCI

Provider Business Mailing Address
First Line	:	1900 BITTERSWEET DR
Second Line	:
City	:	SAINT ANNE
State	:	IL
Zip	:	60964-4335
Country	:	US
Telephone Number	:	317-721-4477
Fax Number	:

Provider Business Practice Location Address
First Line	:	1900 BITTERSWEET DR
Second Line	:
City	:	SAINT ANNE
State	:	IL
Zip	:	60964-4335
Country	:	US
Telephone Number	:	317-721-4477
Fax Number	:

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

Provider Enumeration Date	:	02/11/2021
Last Update Date	:	10/17/2025

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