Individual provider Active NPI

Dalsem Yang

  • Mental Health Counselor
  • New Lenox, IL
National Provider Identifier
1164056321
Registry record updated Feb 26, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
178.014966 Issued in IL
Practice address
1361 E Lincoln Hwy
New Lenox, IL 60451-2153
Phone
(815) 722-4384
NPI assigned
Feb 26, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 26, 2020

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 178.014966 IL Primary

Addresses

Primary practice location

1361 E Lincoln Hwy
New Lenox, IL 60451-2153

Mailing address

311 Deering LN
Bolingbrook, IL 60440-6164

Other practice location 1

5730 W Roosevelt Rd
Chicago, IL 60644-1580
Phone (815) 372-6258

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
178.014966ILMDMental Health Counselor

NPI Registry JSON

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

{
    "created_epoch": "1582675200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1582675200000",
    "number": "1164056321",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "311 DEERING LN",
            "city": "BOLINGBROOK",
            "state": "IL",
            "postal_code": "604406164"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1361 E LINCOLN HWY",
            "city": "NEW LENOX",
            "state": "IL",
            "postal_code": "604512153",
            "telephone_number": "815-722-4384"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "5730 W Roosevelt Rd",
            "address_purpose": "LOCATION",
            "city": "Chicago",
            "state": "IL",
            "postal_code": "606441580",
            "country_code": "US",
            "telephone_number": "815-372-6258",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "YANG",
        "first_name": "DALSEM",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-02-26",
        "last_updated": "2020-02-26",
        "certification_date": "2020-02-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "IL",
            "license": "178.014966",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New Lenox, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 26, 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.