Organization Active NPI

Dwyer-Elias Counseling and Therapy, P.C.

  • Mental Health Counselor
  • Rock Island, IL
National Provider Identifier
1003080144
Registry record updated Apr 18, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
Legal business name
DWYER-ELIAS COUNSELING AND THERAPY, P.C.
Practice address
1800 3Rd Ave
Suite 516
Rock Island, IL 61201-8026
Phone
(309) 788-1050
NPI assigned
Apr 18, 2008
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 18, 2008

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

Authorized official

Name
Ms. Rebecca Ruth Dwyer-Elias, LCSW, LISWNPI 1669431821
Title
Owner
Phone
(309) 788-1050

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health CounselorGroup: 193200000X MULTI-SPECIALTY GROUP 101YM0800X IL Primary

Addresses

Primary practice location

1800 3Rd Ave
Suite 516
Rock Island, IL 61201-8026

Mailing address

2631 Farnam St
Davenport, IA 52803-1809
Phone (563) 326-4881

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20080429000084 IL Part B Supplier - Clinic/Group Practice 0042398273 Receives reassigned benefits from 1 practitioner
Practice locations: Rock Island, IL

National Provider Directory

National Provider Directory

Locations

1800 3rd Ave
Ste 516
Rock Island, IL 61201
Phone (309) 788-1050

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1208476800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1208476800000",
    "number": "1003080144",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2631 FARNAM ST",
            "city": "DAVENPORT",
            "state": "IA",
            "postal_code": "528031809",
            "telephone_number": "563-326-4881"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1800 3RD AVE",
            "address_2": "SUITE 516",
            "city": "ROCK ISLAND",
            "state": "IL",
            "postal_code": "612018026",
            "telephone_number": "309-788-1050"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DWYER-ELIAS COUNSELING AND THERAPY, P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-04-18",
        "last_updated": "2008-04-18",
        "status": "A",
        "authorized_official_last_name": "DWYER-ELIAS",
        "authorized_official_first_name": "REBECCA",
        "authorized_official_middle_name": "RUTH",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "309-788-1050",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "LCSW, LISW"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Mental Health",
            "state": "IL",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Rock Island, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 18, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.