Individual provider Active NPI

Kirsis Allennys Dipre, LPC, NCC

  • Professional Counselor
  • Evanston, IL
National Provider Identifier
1164126736
Registry record updated Apr 3, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
178.018597 Issued in IL
Practice address
415 Howard St Apt 502
Evanston, IL 60202-4047
Phone
(847) 260-8067
NPI assigned
Mar 28, 2023
Last updated
Apr 3, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 3, 2023

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 178.018597 IL Primary

Addresses

Primary practice location

415 Howard St Apt 502
Evanston, IL 60202-4047

Mailing address

415 Howard St Apt 502
Evanston, IL 60202-4047
Phone (847) 260-8067

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
178.018597ILMDProfessional Counselor

NPI Registry JSON

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

{
    "created_epoch": "1679961600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1680480000000",
    "number": "1164126736",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "415 HOWARD ST APT 502",
            "city": "EVANSTON",
            "state": "IL",
            "postal_code": "602024047",
            "telephone_number": "847-260-8067"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "415 HOWARD ST APT 502",
            "city": "EVANSTON",
            "state": "IL",
            "postal_code": "602024047",
            "telephone_number": "847-260-8067"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DIPRE",
        "first_name": "KIRSIS",
        "middle_name": "ALLENNYS",
        "name_prefix": "Dr.",
        "credential": "LPC, NCC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-03-28",
        "last_updated": "2023-04-03",
        "certification_date": "2023-04-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "IL",
            "license": "178.018597",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Evanston, IL

Sources for this page

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

Verify at the official NPI Registry.