Individual provider Active NPI

David Gibbons, MA, LCPC

  • Mental Health Counselor
  • Barrington, IL
National Provider Identifier
1144688912
Registry record updated Jun 3, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
180.012131 Issued in IL
Practice address
330 E Main St Ste 207
Barrington, IL 60010-3203
Phone
(224) 545-1225
Fax
(224) 702-9080
NPI assigned
Feb 8, 2016
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 3, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X 180.012131 IL Primary

Addresses

Primary practice location

330 E Main St Ste 207
Barrington, IL 60010-3203

Mailing address

330 E Main St Ste 207
Barrington, IL 60010-3203
Phone (224) 545-1225

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 Arts

State licenses

LicenseStateTypeSpecialty
180.012131ILMDMental Health Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Mandala Counseling Services LLC Mental Health CurrentSince Jul 28, 2024 Accepting new patients
David Gibbons Jungian Analysis & Counseling, Inc. CurrentSince Jun 9, 2024 Accepting new patients
Borst & Associates Inc PastSince Apr 3, 2010 Accepting new patients

Locations

330 E Main St
Ste 207
Barrington, IL 60010
Phone (224) 545-1225

Organizations & group practices 3

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": "1454889600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1717372800000",
    "number": "1144688912",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "330 E MAIN ST STE 207",
            "city": "BARRINGTON",
            "state": "IL",
            "postal_code": "600103203",
            "telephone_number": "224-545-1225",
            "fax_number": "224-702-9080"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "330 E MAIN ST STE 207",
            "city": "BARRINGTON",
            "state": "IL",
            "postal_code": "600103203",
            "telephone_number": "224-545-1225",
            "fax_number": "224-702-9080"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GIBBONS",
        "first_name": "DAVID",
        "credential": "MA, LCPC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2016-02-08",
        "last_updated": "2024-06-03",
        "certification_date": "2024-06-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "IL",
            "license": "180.012131",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Barrington, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 3, 2024; 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.