Individual provider Active NPI

Katherine Duitsman, MS, LPC, NCC

  • Professional Counselor
  • Champaign, IL
National Provider Identifier
1124637624
Registry record updated Jul 30, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
178009541 Issued in IL
Practice address
301 N Neil St Ste 210
Champaign, IL 61820-3166
Phone
(217) 244-4597
NPI assigned
Jul 30, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 30, 2020

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 178009541 IL Primary

Addresses

Primary practice location

301 N Neil St Ste 210
Champaign, IL 61820-3166

Mailing address

3714 Thornhill Dr
Champaign, IL 61822-3530
Phone (217) 369-2350

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
Credentials
Master of Science

State licenses

LicenseStateTypeSpecialty
178009541ILMDProfessional Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Board of Trustees of the University of Illinois Professional CurrentSince Mar 21, 2021 Accepting new patients

Locations

301 N Neil St
Ste 210
Champaign, IL 61820
Phone (217) 244-4597

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1596067200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1596067200000",
    "number": "1124637624",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3714 THORNHILL DR",
            "city": "CHAMPAIGN",
            "state": "IL",
            "postal_code": "618223530",
            "telephone_number": "217-369-2350"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "301 N NEIL ST STE 210",
            "city": "CHAMPAIGN",
            "state": "IL",
            "postal_code": "618203166",
            "telephone_number": "217-244-4597"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DUITSMAN",
        "first_name": "KATHERINE",
        "credential": "MS, LPC, NCC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-07-30",
        "last_updated": "2020-07-30",
        "certification_date": "2020-07-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "IL",
            "license": "178009541",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Champaign, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 30, 2020; 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.