Individual provider Active NPI

Deanna Elizabeth Damiano, LCPC

  • Professional Counselor
  • Chicago, IL
National Provider Identifier
1083998538
Registry record updated Mar 29, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
180.011243 Issued in IL
Practice address
5710 N Broadway St
Chicago, IL 60660-4302
Phone
(872) 235-0498
NPI assigned
Oct 3, 2011
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 29, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Professional Counselor 101YP2500X 180.011243 IL Primary

Addresses

Primary practice location

5710 N Broadway St
Chicago, IL 60660-4302

Mailing address

5710 N Broadway St
Chicago, IL 60660-4302
Phone (773) 728-1000

Other practice location 1

10532 N Port Washington Rd
Suite 1B
Mequon, WI 53092-5563
Phone (262) 242-3810

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
180.011243ILMDProfessional Counselor

NPI Registry JSON

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

{
    "created_epoch": "1317600000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1553817600000",
    "number": "1083998538",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5710 N BROADWAY ST",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606604302",
            "telephone_number": "773-728-1000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5710 N BROADWAY ST",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606604302",
            "telephone_number": "872-235-0498"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "10532 N Port Washington Rd",
            "address_2": "Suite 1B",
            "address_purpose": "LOCATION",
            "city": "Mequon",
            "state": "WI",
            "postal_code": "530925563",
            "country_code": "US",
            "telephone_number": "262-242-3810",
            "fax_number": "262-242-3816",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DAMIANO",
        "first_name": "DEANNA",
        "middle_name": "ELIZABETH",
        "credential": "LCPC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-10-03",
        "last_updated": "2019-03-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "IL",
            "license": "180.011243",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chicago, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 29, 2019; 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.