Active NPI
Diane Zavala, M.A, LPC, NCC
- Mental Health Counselor
- Algonquin, IL
National Provider Identifier
1164273363
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Mental Health Counselor
- License
- 178020061
- Practice address
- 265 Stonegate Rd Ste 102
Algonquin, IL 60102-5614 - Phone
- (224) 678-9180
- Fax
- (224) 678-9369
- NPI assigned
- Mar 27, 2024
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Professional Counselor | 101YP2500X | 178020061 | IL | |
| Mental Health Counselor | 101YM0800X | 178020061 | IL | Primary |
Addresses
Primary practice location
265 Stonegate Rd Ste 102
Algonquin, IL 60102-5614
Mailing address
111 S Butrick St
Waukegan, IL 60085-5305
Phone (224) 656-2290
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
| License | State | Type | Specialty |
|---|---|---|---|
| 178020061 | IL | MD | Mental Health Counselor |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Epp Advisory Group, Inc. | Mental Health | Current | Accepting new patients |
Locations
265 Stonegate Rd
Ste 102
Algonquin, IL 60102
Phone (224) 232-7482
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": "1711497600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1711497600000",
"number": "1164273363",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "111 S BUTRICK ST",
"city": "WAUKEGAN",
"state": "IL",
"postal_code": "600855305",
"telephone_number": "224-656-2290"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "265 STONEGATE RD STE 102",
"city": "ALGONQUIN",
"state": "IL",
"postal_code": "601025614",
"telephone_number": "224-678-9180",
"fax_number": "224-678-9369"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ZAVALA",
"first_name": "DIANE",
"name_prefix": "Mrs.",
"credential": "M.A, LPC, NCC",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2024-03-27",
"last_updated": "2024-03-27",
"certification_date": "2024-03-27",
"status": "A"
},
"taxonomies": [
{
"code": "101YP2500X",
"taxonomy_group": "",
"desc": "Counselor, Professional",
"state": "IL",
"license": "178020061",
"primary": false
},
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": "IL",
"license": "178020061",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Algonquin, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 27, 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.