Active NPI
Bryan D Joseph
- Mental Health Counselor
- Elgin, IL
National Provider Identifier
1134827165
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Mental Health Counselor
- Practice address
- 695 S State St
Elgin, IL 60123-7673 - Phone
- (630) 995-2082
- NPI assigned
- Feb 20, 2023
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | IL | Primary |
Addresses
Primary practice location
695 S State St
Elgin, IL 60123-7673
Mailing address
695 S State St
Elgin, IL 60123-7673
Phone (630) 995-2082
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 362472748 | Medicaid | IL |
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Other URL | Health | Health Information Exchange (HIE) |
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
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1676851200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1676851200000",
"number": "1134827165",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "695 S STATE ST",
"city": "ELGIN",
"state": "IL",
"postal_code": "601237673",
"telephone_number": "630-995-2082"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "695 S STATE ST",
"city": "ELGIN",
"state": "IL",
"postal_code": "601237673",
"telephone_number": "630-995-2082"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JOSEPH",
"first_name": "BRYAN",
"middle_name": "D",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2023-02-20",
"last_updated": "2023-02-20",
"certification_date": "2023-02-20",
"status": "A"
},
"taxonomies": [
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": "IL",
"license": null,
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "362472748",
"state": "IL"
}
],
"endpoints": [
{
"endpointType": "OTHERS",
"endpointTypeDescription": "Other URL",
"endpoint": "Health",
"affiliation": "N",
"endpointDescription": "Not for Profit",
"use": "HIE",
"useDescription": "Health Information Exchange (HIE)",
"contentType": "CSV",
"contentTypeDescription": "CSV",
"address_1": "695 S State St",
"city": "Elgin",
"state": "IL",
"country_code": "US",
"postal_code": "601237673",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}Other providers in Elgin, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 20, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.