Davide Pace

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

Practice address

88 S Main St
Glen Carbon, IL 62034-1415

Phone

(618) 288-8085

Fax

(618) 288-8959

NPI assigned

Jul 11, 2024

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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

{
    "created_epoch": "1720656000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1720656000000",
    "number": "1013754670",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "88 S MAIN ST",
            "city": "GLEN CARBON",
            "state": "IL",
            "postal_code": "620341415",
            "telephone_number": "618-288-8085",
            "fax_number": "618-288-8959"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "88 S MAIN ST",
            "city": "GLEN CARBON",
            "state": "IL",
            "postal_code": "620341415",
            "telephone_number": "618-288-8085",
            "fax_number": "618-288-8959"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "200 W 3rd St Ste And706",
            "address_purpose": "LOCATION",
            "city": "Alton",
            "state": "IL",
            "postal_code": "620026180",
            "country_code": "US",
            "telephone_number": "618-288-8085",
            "fax_number": "618-288-8959",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PACE",
        "first_name": "DAVIDE",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2024-07-11",
        "last_updated": "2024-07-11",
        "certification_date": "2024-07-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "4A00-IPI-032",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Mental Health Counselor in Glen Carbon, IL
• Providers in Glen Carbon, IL by specialty
• Mental Health Counselor in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 11, 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.