Debra Louise Blumthal, NCC, LCPC

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

180006218 Issued in IL

Practice address

215 S Grand Ave W
Springfield, IL 62704-3838

Phone

(217) 744-3525

Fax

(217) 744-2525

NPI assigned

Mar 4, 2007

Sex

Female

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

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Gene a Brodland LCSW, LLC

  • Community/Behavioral Health Agency
  • Springfield, IL
  • NPI 1528466430
  NPD (past)

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

{
    "created_epoch": "1172966400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1438300800000",
    "number": "1063541308",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "215 S GRAND AVE W",
            "city": "SPRINGFIELD",
            "state": "IL",
            "postal_code": "627043838",
            "telephone_number": "217-744-3525",
            "fax_number": "217-744-2525"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "215 S GRAND AVE W",
            "city": "SPRINGFIELD",
            "state": "IL",
            "postal_code": "627043838",
            "telephone_number": "217-744-3525",
            "fax_number": "217-744-2525"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BLUMTHAL",
        "first_name": "DEBRA",
        "middle_name": "LOUISE",
        "credential": "NCC, LCPC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-03-04",
        "last_updated": "2015-07-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "IL",
            "license": "180006218",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE LICENSE NUMBER-LCPC",
            "identifier": "180.006218",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Bloom Counseling and Associates
• Joan Bloome, MSCCC/SLP
• Jackson Blough
• Victoria L Blount, CCC-A
• Blue Mind Counseling PLLC
• Robert James Blumthal, O.D.
• Richard E. Blunk, O.D.
• Julie A Blythe, RN, MSW, LCSW, CCTP
• Board of Trustees of Southern Illinois University
• Board of Trustees of Southern Illinois University

• Professional Counselor in Springfield, IL
• Providers in Springfield, IL by specialty
• Professional Counselor in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 31, 2015; 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.