Dale Alan Guebert, LCPC

Primary specialty

CounselorTaxonomy code 101Y00000X

Practice address

4709 44 St
Suite #5
Rock Island, IL 61201-7187

Phone

(309) 793-3460

Fax

(309) 732-0551

NPI assigned

Feb 9, 2007

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in IL

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Mental Health Counselor

Education

Other, 2001

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Southpark Psychology LTDGroup PAC ID 8527203090, 21 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Southpark Psychology LTD

  • Counseling Psychologist
  • Moline, IL
  • NPI 1558470419
  Medicare reassignment Care Compare group NPD
• Advanced Cardiovascular Consultants,SC

  • Specialist
  • Moline, IL
  • NPI 1588718910
  NPD
• Youth Service Bureau of Rock Island Co.

  • Mental Health Counselor
  • Rock Island, IL
  • NPI 1396922084
  NPD (past)

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

{
    "created_epoch": "1170979200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1083755433",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4709 44 ST",
            "address_2": "SUITE #5",
            "city": "ROCK ISLAND",
            "state": "IL",
            "postal_code": "612017187",
            "telephone_number": "309-793-3460",
            "fax_number": "309-732-0551"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4709 44 ST",
            "address_2": "SUITE #5",
            "city": "ROCK ISLAND",
            "state": "IL",
            "postal_code": "612017187",
            "telephone_number": "309-793-3460",
            "fax_number": "309-732-0551"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GUEBERT",
        "first_name": "DALE",
        "middle_name": "ALAN",
        "name_prefix": "Mr.",
        "credential": "LCPC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-02-09",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": "IL",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Freya Deanna Greene
• Matthew Greer
• Cindy J Griffith, RPH
• Scott Jeffrey Griffith, LMSW
• Tricia Gross
• Chasity M. Gushulak-St Amand, FNP STUDENT
• Sandra Guzman, MSED
• Lindsey Hageman, L.P.C.
• Logan Hagerman
• Susan Kathrine Hagmann, BSN,RN

• Counselor in Rock Island, IL
• Providers in Rock Island, IL by specialty
• Counselor in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.