Organization Active NPI

Dillingham Counseling Services

  • Community/Behavioral Health Agency
  • Evansville, IN
National Provider Identifier
1043875149
Registry record updated May 15, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Behavioral Health AgencyTaxonomy code 251S00000X
Legal business name
DILLINGHAM COUNSELING SERVICES
Practice address
5200 Washington Ave Ste D
Evansville, IN 47715-4863
Phone
(812) 437-1700
Fax
(812) 437-1702
NPI assigned
May 3, 2019
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 15, 2019

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

Authorized official

Name
Leona Jan Dillingham, LCSWNPI 1255676847
Title
Therapist
Phone
(812) 437-1700

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
Community/Behavioral Health Agency 251S00000X Primary

Addresses

Primary practice location

5200 Washington Ave Ste D
Evansville, IN 47715-4863

Mailing address

5200 Washington Ave Ste D
Evansville, IN 47715-4863
Phone (812) 437-1700

Other identifiers 1

IdentifierTypeStateIssuer
340077004AOtherINLCSW LICENSE

Other names 1

  • Reflections Counseling Associates Other name

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address rca_leona@outlook.com Direct

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20190806002220 IN Part B Supplier - Clinic/Group Practice 3476880048 Receives reassigned benefits from 1 practitioner
Practice locations: Evansville, IN

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1556841600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1557878400000",
    "number": "1043875149",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5200 WASHINGTON AVE STE D",
            "city": "EVANSVILLE",
            "state": "IN",
            "postal_code": "477154863",
            "telephone_number": "812-437-1700",
            "fax_number": "812-437-1702"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5200 WASHINGTON AVE STE D",
            "city": "EVANSVILLE",
            "state": "IN",
            "postal_code": "477154863",
            "telephone_number": "812-437-1700",
            "fax_number": "812-437-1702"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DILLINGHAM COUNSELING SERVICES",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-05-03",
        "last_updated": "2019-05-15",
        "status": "A",
        "authorized_official_last_name": "DILLINGHAM",
        "authorized_official_first_name": "LEONA",
        "authorized_official_middle_name": "JAN",
        "authorized_official_title_or_position": "THERAPIST",
        "authorized_official_telephone_number": "812-437-1700",
        "authorized_official_credential": "LCSW"
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LCSW LICENSE",
            "identifier": "340077004A",
            "state": "IN"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "rca_leona@outlook.com",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "5200 Washington Ave Ste D",
            "city": "Evansville",
            "state": "IN",
            "country_code": "US",
            "postal_code": "477154863",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "organization_name": "Reflections Counseling Associates",
            "code": "5",
            "type": "Other Name"
        },
        {
            "organization_name": "Reflections Counseling Associates",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Evansville, IN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 15, 2019; 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.